Prevalence of Transitional vertebrae in low back pain patients

What is it about?

Introduction: Lumbosacral transitional vertebrae (LSTV) are a common congenital anomaly. Low back pain associated with an LSTV is still somewhat controversial, beyond dispute is the importance of identifying an LSTV in patients in whom a surgical procedure is planned. Objective: The aim of this study was to determine the prevalence of LSTV, identifying on plain anteroposterior and lateral radiographs of the lumbosacral spine. This study was attempted to assess whether LSTV correlates with low back pain and increase awareness among all clinicians to reduce the risk of surgical and procedural errors in patients with LSTV. Materials & Methods: A retrospective review of 5951 lumbosacral radiographs of low back pain patients were examined. Transitional vertebrae were identified and graded according to the Castellvi classification of LSTV in 540 patients(281women and 259 men; aged 16–73 years). Results: The prevalence of LSTV in the study population was 9.9 %( 540 of 5439), with higher rate in women than in men (5.17% vs. 4.76% respectively). Of the 540 individuals with LSTV, 4.2% were type II (pseudoarticulation), 4.7% were type III (fusion), and 1.0% was type IV (one transverse process fused and one with pseudoarticulation). Lumbarized S1 and sacralized L5 were seen in 5.79 and 4.13% of patients, respectively. Type I LSTV was excluded in our study as they lack of clinical and surgical significance. Conclusion: This study concluded that LSTV are a common in the low back pain population. It is also essential that all clinicians should be aware of this common congenital anomaly to avoid an intervention or surgery at an incorrect level. Key words: Lumbosacral transitional vertebrae; Low back pain; Lumbarization; Sacralization

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