Is lumbosacral transitional vertebra associated with lumbar disc herniation in patients with low back pain?

Yıldız, Fatma F; Balaban, Mehtap; Hatipoğlu, Şükrü Cem; Veizi, Enejd

doi:10.1007/s00586-022-07372-y

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…It was previously known worldwide that disc and facet degenerations, which present as only LSTV-related degenerative findings, usually occur with increasing age. Subsequent studies have found a correlation between disc degeneration and LSTV, with three or more intervertebral disc levels being affected with the occurrence of LSTV, especially in young adults in whom the presence of LSTV significantly increases the incidence of disc degeneration 52 – 54 . Moreover, numerous studies have confirmed that discs above the transitional vertebra are more prone to early degeneration, while discs between the transitional vertebra and the sacrum are less prone to degeneration 7 , 12 , 16 .…”

Section: Discussionmentioning

confidence: 99%

A systematic review and bibliometric study of Bertolotti’s syndrome: clinical characteristics and global trends

Zhu

Ding

Zheng

et al. 2023

International Journal of Surgery

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Purpose: Bertolotti’s syndrome is a prevalent congenital deformity. However, many physicians fail to include it in their differential diagnosis for low back pain (LBP), which results in missed diagnosis or misdiagnosis. There is still a lack of standardized treatment and management strategies for Bertolotti’s syndrome. This study aimed to review the clinical characteristics and management of Bertolotti’s syndrome and reports bibliometric insights in advancements in Bertolotti’s syndrome research. Methods: Studies published until 30 September 2022 were systematically reviewed according to the PRISMA guidelines. Three independent reviewers extracted the data and assessed the quality and risk of bias of the studies based on the methodological index of non-randomized studies (MINORS). SPSS, VOS viewer, and the Citespace software were used for the systematic review, visual analysis, data mining, mapping, and clustering of the retrieved articles, which presented clear and visual presentations of the structural patterns of published research in graphs. Result: A total of 118 articles, describing a total of 419 patients with Bertolotti’s syndrome, were included. There was an upward trend with a steady increase in the number of publications. The world map distribution showed that most publications were predominantly from North America and Asia. The most cited articles were published in the following journals: Spine, J Bone Joint Surg, and Radiology. The mean age of the patients was 47.7 years, and 49.6% of them were male. A total of 159 (96.4%) patients had LBP symptoms. The mean symptom duration was 41.4 months (74.8%), and most of the patients had Castellvi type II. Disc degeneration was the most reported comorbid spinal diseases. The mean methodological index of non-randomized studies score was 4.16±3.95 points (range, 1–21). A total of 265 (68.3%) patients underwent surgical treatments. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration were the current main research areas of Bertolotti’s syndrome. Conclusions: The steady increase in the number of publications demonstrated the increased attention of researchers on this topic. Our results showed a significant prevalence of Bertolotti’s syndrome in patients with LBP and a long symptom duration before the initiation of treatment. Surgical treatments were commonly used to treat patients with Bertolotti’s syndrome after a non-effective conservative treatment. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration are the major research areas of Bertolotti’s syndrome.

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Section: Discussionmentioning

confidence: 99%

A systematic review and bibliometric study of Bertolotti’s syndrome: clinical characteristics and global trends

Zhu

Ding

Zheng

et al. 2023

International Journal of Surgery

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“…An increased frequency of lumbar disc herniation was detected in the presence of LSTV. Furthermore, higher degeneration incurred at the L3–L4 and L4–L5 intervertebral levels 34 . Transitional deformity of the lumbosacral region restricts the usual movement observed normally at the L5–S1 level.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, higher degeneration incurred at the L3-L4 and L4-L5 intervertebral levels. 34 Transitional deformity of the lumbosacral region restricts the usual movement observed normally at the L5-S1 level. Due to this restriction, the segment immediately above the transitional segment becomes more hypermobile, which may create segmental instability.…”

Section: Discussionmentioning

confidence: 99%

The effect of lumbosacral transitional vertebra on lumbar spine degeneration and spondylolisthesis among patients with low back pain

Benlidayı

Tirasci

2023

Pain Practice

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AimTo examine the impact of lumbosacral transitional vertebra (LSTV) on lumbar spine degeneration, disc protrusion, and spondylolisthesis among patients with low back pain.MethodsThe records of the patients who had undergone anterioposterior lumbar radiographs and lumbar magnetic resonance imaging (MRI) for low back pain between November 2014 and September 2021 were extracted retrospectively and assessed for eligibility. Of the remaining patients, those with LSTV were assigned as “case group.” Age‐ and sex‐matched patients without LSTV were assigned as “control group.” On digitalized lumbar MRIs, Modic degeneration (type I–III) and Pfirrman's disc degeneration (grade I–V) immediately cephalad to the transitional level were evaluated; intervertebral disc height (mm), disc protrusion (mm), and percentage of vertebral slippage (%) were measured.ResultsOf the 501 patients with low back pain, 128 ineligible patients were excluded; 113 patients with LSTV and 117 age‐ and sex‐matched controls were included in the study. LSTV group revealed decreased intervertebral disc height, increased vertebral endplate degeneration, and slippage, as well as increased disc degeneration and protrusion when compared with controls (p < 0.001). Patients with type III LSTV had greater disc protrusion and higher percentage of slippage compared to those with type I LSTV (p = 0.008 and p = 0.009, respectively). Vertebral endplate degeneration, disc height, and disc degeneration did not differ across categories of LSTV type.ConclusionLumbosacral transitional vertebra malformation is related to decreased intervertebral disc height, increased disc degeneration, vertebral endplate degeneration, disc protrusion, and slippage above the level of transition. Patients with type III LSTV revealed the highest percentage of slippage and disc protrusion.

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“…Furthermore, there are several subtypes of LSTV. Some researchers believe that sacralization can lead to a more abnormal increase in segmental stress, just like the pathological changes after a spinal fusion (24,28). Besides, unilateral LSTV may lead to asymmetric stress on the lumbar spine and thus more severe degeneration compared with bilateral LSTV (28).…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers believe that sacralization can lead to a more abnormal increase in segmental stress, just like the pathological changes after a spinal fusion (24,28). Besides, unilateral LSTV may lead to asymmetric stress on the lumbar spine and thus more severe degeneration compared with bilateral LSTV (28). However, the influence of these subtypes is still under controversial and most of the previous studies tended to regard LSTV as a unified feature (24,25).…”

Section: Discussionmentioning

confidence: 99%

Identification of preoperative radiological risk factors for reoperation following percutaneous endoscopic lumbar decompression to treat degenerative lumbar spinal stenosis

Wang

Wang²,

Zang³

et al. 2023

Front. Surg.

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BackgroundThis study aimed to identify radiological risk factors associated with reoperation after percutaneous transforaminal endoscopic decompression (PTED) for degenerative lumbar spinal stenosis (DLSS).MethodsThe preoperative clinical data of 527 consecutive patients with DLSS who underwent PTED were retrospectively reviewed. Overall, 44 patients who underwent reoperation were matched for age, sex, body mass index, and surgical segment to 132 control patients with excellent or good clinical outcomes. Radiological characteristics were compared between the groups using independent sample t-tests and Pearson's chi-square tests. A predictive model was established based on multivariate logistic regression analysis.ResultsThe analyses revealed significant differences in the presence of lumbosacral transitional vertebra (LSTV, 43.2% vs. 17.4%, p = 0.001), the number of levels with senior-grade disc degeneration (2.57 vs. 1.96, p = 0.018) and facet degeneration (1.91 vs. 1.25 p = 0.002), and the skeletal muscle index (SMI, 849.7 mm2/m2 vs. 1008.7 mm2/m2, p < 0.001) between patients in the reoperation and control groups. The results of the logistic analysis demonstrated that LSTV (odds ratio [OR] = 2.734, 95% confidence interval [CI]:1.222–6.117, p < 0.014), number of levels with senior-grade facet degeneration (OR = 1.622, 95% CI:1.137–2.315, p = 0.008), and SMI (OR = 0.997, 95% CI:0.995–0.999, p = 0.001) were associated with reoperation after PTED. The application of the nomogram based on these three factors showed good discrimination (area under the receiver operating characteristic curve 0.754, 95% CI 0.670–0.837) and good calibration.ConclusionLSTV, more levels with senior-grade facet degeneration, and severe paraspinal muscle atrophy are independent risk factors for reoperation after PTED. These factors can thus be used to predict reoperation risk and to help tailor treatment plans for patients with DLSS.

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Is lumbosacral transitional vertebra associated with lumbar disc herniation in patients with low back pain?

Cited by 6 publications

References 29 publications

A systematic review and bibliometric study of Bertolotti’s syndrome: clinical characteristics and global trends

A systematic review and bibliometric study of Bertolotti’s syndrome: clinical characteristics and global trends

The effect of lumbosacral transitional vertebra on lumbar spine degeneration and spondylolisthesis among patients with low back pain

Identification of preoperative radiological risk factors for reoperation following percutaneous endoscopic lumbar decompression to treat degenerative lumbar spinal stenosis

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