Detection of foramina at the sacral ala is not very uncommon and has been reported earlier in the literature. It has also been suggested that occurrence of such a foramen may be associated with similar findings at adjacent lumbar transverse processes. This report documents detection of a similar occurrence and reviews commonly accepted embryological explanations of this phenomenon. Pedicle or alar instrumentations in these individuals warrants careful per-operative imaging of these foramina due to the likelihood of these formina containing remnants of longitudinally anastomosing vascular structures, in most instances.
