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ORIGINAL ARTICLE
Year : 2019  |  Volume : 68  |  Issue : 2  |  Page : 123-128

Lumbosacral transitional vertebrae in patients with low back pain: Radiological classification and morphometric analysis


1 Department of Anatomy, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India
3 Department of Anatomy, Christian Medical College, Ludhiana, Punjab, India

Correspondence Address:
Dr. Jerry Joseph Joel
Department of Anaesthesia, Christian Medical College, Vellore - 632 002, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JASI.JASI_61_19

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Introduction: Lumbosacral transitional vertebrae (LSTV) are a congenital variation found in patients incidentally. The aim of this study was to find the prevalence of LSTV and to study its morphometric parameters radiologically in comparison with patients with no LSTV, in low back pain patients in Punjabi population. Material and Methods: The anteroposterior (AP) and lateral lumbosacral spinal radiographs of 100 patients with low back pain were studied. LSTV were identified and classified based on the Castellvi classification. The width of the transverse processes, superior and inferior vertebral end plate, mid-AP diameter and height of the L5 vertebra, and L5–S1 disc height were measured. All parameters were statistically analyzed and compared between normal and LSTV patients. Results: LSTV were found in 22% of low back pain patients, all comprising sacralization of L5, most common Castellvi type being IIA (31.9%). There were a statistically significant increase in the width of transverse processes of L5 vertebrae on both the right and left sides (P < 0.001 each) and a significant increase in height of L5 body (P = 0.03), with a decrease in L5–S1 disc height (P = 0.05) in low back pain patients with LSTV in comparison with patients without LSTV. Discussion and Conclusions: LSTV is a common congenital anatomical variation found in patients with low back pain. An increased height of L5 vertebra with a decreased L5–S1 disc height is found to be related to LSTV and can be useful for radiologically suspecting LSTV in patients with low back pain.


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