Sagittal radiographic parameters in the presence of lumbosacral transitional vertebra (LSTV): relationships between measurements using the upper vs lower transitional vertebra

2021 ◽  
Author(s):  
Cole J. Homer ◽  
Jonathan N. Sembrano
2019 ◽  
Vol 30 (6) ◽  
pp. 767-771
Author(s):  
Xinqiang Yao ◽  
Ruoting Ding ◽  
Junhao Liu ◽  
Siyuan Zhu ◽  
Jingshen Zhuang ◽  
...  

OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis.


2021 ◽  
Vol 65 ◽  
pp. 29-32
Author(s):  
R Vaidya ◽  
M Bhatia

Introduction: Lumbosacral transitional vertebra (LSTV) is a common anomaly of the lumbosacral junction with a prevalence of 4–35.9% in various studies. Plain radiography of the spine in anteroposterior and lateral projections is done for the evaluation of the spine in candidates coming for medical evaluation for flying duties in the armed forces. Material and Methods: An observational study was conducted on the whole spine series of radiographs done at a medical selection establishment. The study population included candidates reporting to the establishment for medical examination to ascertain fitness for flying duties. In a small subset of this study population having LSTV, the Ferguson’s view was done to better delineate the lumbosacral junction. Results: The analysis revealed a total 148 cases of LSTV with a prevalence of 13.9%. Ferguson’s view, undertaken among 30 doubtful cases, confirmed the presence of LSTV in 27 cases. Type IIa was observed to be the most common pattern of LSTV followed by Type IIIb. As per the existing policy, 63.8% of candidates with LSTV were considered unfit for flying duties. Conclusion: Flying duties in the armed forces require the highest standard of physical fitness. LSTV is a very common finding during the evaluation of candidates and it is appropriate that the cases of LSTV be evaluated thoroughly. In doubtful cases of LSTV, the Ferguson’s view is a useful supplementary view as it clearly delineates the lumbosacral junction.


2013 ◽  
Vol 56 (3) ◽  
pp. 126-129
Author(s):  
George Paraskevas ◽  
Maria Tzika ◽  
Panagiotis Kitsoulis

Congenital malformations such as lumbosacral transitional vertebrae and spina bifida occulta constitute unrare anomalies and could affect the symptomatology of low back pain. A transitional vertebra is characterized by elongation of one or both transverse processes, leading to the appearance of a sacralized fifth lumbar vertebra or a lumbarized first sacral vertebra. Furthermore, sacral spina bifida occulta is a developmental anomaly that corresponds to the incomplete closure of the vertebral column. In the present case report, we describe a case of a dried sacrum presenting a partially sacralized fifth lumbar vertebra and total spina bifida, extended from first to fifth sacral vertebra. A pseudoarthrosis is formed on the left side and the specimen could be incorporated in Castellvi’s type IIa. Moreover, the incidence, morphology, clinical and surgical significance of these spinal malformations are discussed.


1991 ◽  
Vol 40 (1) ◽  
pp. 243-244
Author(s):  
Hideki Sonoda ◽  
Tetsuya Hirano ◽  
Haruaki Takeuchi ◽  
Kunihiko Tomoda ◽  
Kenichi Yamashiro ◽  
...  

2020 ◽  
Author(s):  
Lisheng Hou ◽  
Xuedong Bai ◽  
Haifeng Li ◽  
Tianjun Gao ◽  
Wei Li ◽  
...  

Abstract Background: The anteroposterior view of lumbar plain radiograph (AP-LPR) was chosen as the original and first radiographic tool to determine and classify lumbosacral transitional vertebra with morphological abnormality (MA-LSTV) according to Castellvi Classification. However, recent studies found that AP-LPR might not sufficient to detect or classify MA-LSTV correctly. The present study aims to verify the reliability of AP-LPR on detecting and classifying MA-LSTV types, taking coronal reconstructed CT images (CT-CRIs) as gold criteria. Methods : Patients with suspected MA-LSTVs determined by AP-LPR were initially enrolled. Among them, those who received CT-CRIs were formally enrolled to verify the sensitivity of AP-LPR on detecting and classifying MA-LSTV types according to Castellvi classification principle. Results : 298 cases were initially enrolled as suspected MA-LSTV ones, among whom 91 cases who received CT-CRIs were enrolled into the final study group. All suspected MA-LSTVs were verified to be real MA-LSTV ones by CT-CRIs. However, 35.2% of the suspected MA-LSTVs types judged by AP –LPR were not consistent with final types judged by CT-CRIs. Two suspected type IIIa and 20 suspected IIIb ones were verified to be true, while 9 of 39 suspected IIa, 9 and 3 of 17 suspected IIb , and 11 of 13 suspected IV ones were verified to be real type IIIa, IIIb, IV and IIIb ones by CT-CRIs, respectively. Incomplete joint-like structure (JLS) or bony union structure (BUS), and remnants of sclerotic band (RSB) between the transverse process (TP) and sacrum were considered to be the main reasons for misclassification. Conclusion : Although AP-LPR could detect MA-LSTV correctly, it could not give accurate type classification. CT-CRIs could provide detailed information between the TP and sacrum area, and could be taken as gold standard to detect and classify MA-LSTV.


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