A review of lumbosacral transitional vertebrae and associated vertebral numeration

Lian, Jayson; Levine, Nicole L.; Cho, Woojin

doi:10.1007/s00586-018-5554-8

Cited by 44 publications

(33 citation statements)

References 47 publications

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“…Moreover, we did not study the prevalence of sixth lumbar vertebra. When considering the vertebral numeration, the only reliable method has been found to be imaging of the whole sagittal spine [33]. Due to the nature of our study, we could not provide this data.…”

Section: Discussionmentioning

confidence: 93%

Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans

et al. 2020

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Objectives To assess the prevalence of lumbosacral transitional vertebra (LSTV) and associated spinal degenerative changes on abdominal CT scans in Caucasian population. Material and methods A total of 3855 abdominal CT scans of the year 2017 from a single hospital were retrospectively assessed for LSTV, disc degeneration (DD), and facet joint degeneration (FD). An age-and sex-matched 150-subject control group without LSTV was picked at random. Multivariable logistic regression was used for the analysis. Results LSTV was found in 1101 (29%) scans: Castellvi type I in 68%, type II in 16%, type III in 13%, and type IV in 3% of scans. Age-and sex-adjusted prevalence of DD was significantly higher in Castellvi type II and III groups at multiple lumbar levels, and in IV group at L4/5 than in control group (p < 0.001-0.034). At L5/S1, the prevalence of DD was significantly higher in the control group than in type II, III, or IV groups (p < 0.001-0.017). After combining Castellvi types II, III, and IV into one group, significant differences were found at all lumbar levels except L2/3 (p < 0.001-0.016). Prevalence of FD was significantly higher at L4/5 in Castellvi groups I, II, and III than in the control group (p < 0.001-0.002). When Castellvi types II, III, and IV were combined into one group, significant differences were found at lumbar levels L2/3, L3/4, and L4/5 (p < 0.001-0.021). Conclusion Lumbosacral vertebrae of Castellvi types II, III, and IV are associated with greater lumbar degeneration, warranting meticulous evaluation of spinal anatomy, even on CT. Key Points • Lumbosacral transitional vertebra is a common incidental finding on abdominal CT scans with a high prevalence of 29%. • When assessing whole lumbar spine, lumbosacral vertebrae of Castellvi types II, III, and IV were associated with greater lumbar degeneration, warranting careful evaluation of the lumbar spine on abdominal CT scans.

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Section: Discussionmentioning

confidence: 93%

Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans

et al. 2020

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“…The reported incidences of numerical variations of lumbar vertebrae and that of lumbosacral transitional vertebrae were 3.3% to 5.5% and 7.7% to 10.6%, respectively. [13][14][15][16][17] The preoperative recognition of these lumbosacral variations is crucial to prevent wrong-level surgery. Navigation software is not only able to simulate whether the S2AI screw can be inserted, but also is able to detect lumbosacral transitional vertebrae.…”

Section: Discussionmentioning

confidence: 99%

Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

Tatara

Niimura

Sekiya

et al. 2020

Global Spine Journal

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Study Design: A novel technique for S2-alar-iliac (S2AI) screw placement was analyzed. Objectives: Accurate confirmation of the S2AI screw trajectory with free-hand techniques is not simple, although some anatomical landmarks have been reported. To overcome the drawback, we aimed to introduce our technique for S2AI screw placement assisted with a guidewire using a new anatomical landmark. Methods: A total of 104 S2AI screws of 52 patients who underwent S2AI screw placement were investigated. Navigation software was used to simulate S2AI screw placement preoperatively. Screw placement was performed with the nonfluoroscopic free-hand technique. In this technique, a guidewire is inserted into the ilium from the extra-articular portion of the sacroiliac joint just lateral to the ideal screw entry point toward the tip of the greater trochanter and guides the screw trajectory. If the direction of the guidewire is satisfactory, all procedures of screw insertion are performed accordingly. The screw accuracy was assessed with computed tomography. Results: The modal size of the screw was 9.5 mm × 90 mm. The average horizontal angle was 42.0° (SD = 5.1°) on the right and 40.7° (SD = 4.7°) on the left. Of the 104 screws, 4 screws (3.9%) breached dorsally. No screw-related complication was observed. Conclusions: Because the guidewire can be inserted at an angle according to the individual morphology of the sacroiliac joint, it will be a reliable guide for the screw trajectory. This technique with a guidewire would help improve the accuracy of S2AI screw placement.

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“…Giriş Lumbosakral geçiş vertebra (GV) yaygın bir konjenital anomali olup sıklığı %3 ile %35,6 arasında olduğu bildirilmektedir (1)(2)(3)(4)(5)(6).…”

Section: Lumbosakral Geçiş Vertebrasının Numaralandırılmasında Paraspunclassified

“…Sakralize bir L5 genişlemiş transvers proçesden/ proçeslerden tam sakral füzyona kadar değişen morfolojik özellikler gösterir. Lumbarize S1 ise sagital görüntülerde lomber vertebralar gibi kare şeklinde görülebilir ve/veya lomber tip faset eklemlere sahip olabilir (2). Bu nedenle rutin lumbosakral görüntülemede GV'nin doğru olarak numaralandırılması zordur.…”

Section: Lumbosakral Geçiş Vertebrasının Numaralandırılmasında Paraspunclassified

“…Rutin lumbosakral görüntülemelerde GV saptanabilir ancak doğru vertebral numaralandırmada tüm vertebrayı içine alan görüntülemeler altın standart olarak kullanılır. Bunun için genellikle tüm omurga radyografisi veya tüm omurgayı içine alan sagital T2 ağırlıklı görüntüler kullanılmıştır (1,2,5,8 GV'ye sahip olgularda ÇA orijini 2 olguda (%3,9) T11-12 intervertebral disk, 34 olguda (%66,7) T12 vertebra, 1 olguda (%2) T12-L1 intervertebral disk, 14 olguda (%27,5) L1 vertebra seviyesine denk gelmekte idi. Kontrol grubunda ÇA orijini 136 olguda (%41,3) T12 vertebra, 7 olguda (%2,1) T12-L1 intervertebral disk, 186 olguda (%56,5) L1 vertebra düzeyine denk gelmekte idi.…”

Section: Lumbosakral Geçiş Vertebrasının Numaralandırılmasında Paraspunclassified

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The Evaluation of Paraspinal Markers in the Numbering of the Lumbosacral Transitional Vertebrae

Beyazal¹,

Beyazal²,

Kadıoğlu³

et al. 2019

Tod

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Objective: Lumbosacral transitional vertebrae (TV) are a common congenital anomaly and known to be associated with chronic low back pain. The purpose of this study is to reveal the value of the paraspinal markers such as celiac artery (CA), superior mesenteric artery (SMA), right renal artery (RRA) origins, abdominal aorta bifurcation (AAB), and iliolumbar ligament (IL) in the correct numbering of lumbosacral TV on computed tomography (CT) imaging. Materials and Methods: The cases with aged from 18-65 years who underwent the whole-body CT imaging between the dates January 2015 and December 2017 were assessed retrospectively. Results: Of the 380 cases (age 53.4±10.8 years; 164 women and 216 men) included in the study, 51 (13.4%) had TV. A significant difference was determined in terms of the level of CA, SMA, RRA origin, AAB, and IL between the cases with TV and normal spinal segmentation (p<0.001). Conclusion: There are significant differences in terms of the localization of the CA, SMA, RRA origins, AAB, and IL levels between the subjects with normal spinal segmentation and TV. Therefore, the use of these marks may result in inaccuracy of the vertebral numbering.

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A review of lumbosacral transitional vertebrae and associated vertebral numeration

Cited by 44 publications

References 47 publications

Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans

Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans

Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

The Evaluation of Paraspinal Markers in the Numbering of the Lumbosacral Transitional Vertebrae

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