L5 is the most inferior lumbar vertebra and the site of the most common lumbar disc herniation at the L5-S1 level, affecting the L5 nerve root which controls dorsiflexion, big toe extension, and the lateral leg sensation.
| Articulations |
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| Ossification | As per lumbar vertebra pattern, with the transverse processes having separate ossification centres that persist as accessory bones in some individuals. |
L5 is the most common site of spondylolysis (pars interarticularis stress fracture) and the resulting spondylolisthesis (forward slip on S1). L5-S1 is the most common lumbar disc herniation level, compressing the S1 root to produce posterior leg and lateral foot pain, absent ankle reflex, and plantarflexion weakness. L5 has the largest and most wedge-shaped body of the lumbar vertebrae, contributing to the lumbosacral angle.
A stress fracture of the L5 pars interarticularis, common in young athletes who repetitively hyperextend, such as gymnasts and fast bowlers.
Bilateral pars defects allow L5 to slip forward on S1, causing low back pain, hamstring tightness, and sometimes L5 radiculopathy.
Herniation at the lumbosacral level compresses the S1 root, causing posterior leg sciatica, weak plantarflexion, and a reduced ankle jerk.
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