Congenital/developmental
Congenital malformations, such as hemivertebra, and block vertebra, can cause deformation of the spine with or without pain.60If pain is present, it is usually mechanical pain due to degenerative changes in adjacent segments. Syrinx is caused by partial obstruction of the CSF flow from various causes, and it is usually painless. Neurologically, it presents as a kind of central cord syndrome, with upper extremity weakness and diminished pain and temperature sensation in a ”mantle-like” shape, is observed and develops gradually in years. Vibration and proprioception sensations remain relatively intact.61 Chiari malformations can cause headaches and neck pain with various neurological problems (myelopathy, cerebellar symptoms, and central cord syndrome) due to pressure on the brain stem and cervical cord and development of a syrinx.61Bertolotti syndrome (lumbosacral transitional vertebra) is a congenital pseudoarthrosis of a transverse process of L5 with the ileum or the sacrum.62 Mechanical low back pain is typical in young adults.