The transitional vertebra and sacroiliac joint dysfunction association

Illeez, Ozge Gulsum; Atici, Arzu; Ulger, Esra Bahadır; Külcü, Duygu Geler; Özkan, Feyza Ünlü; Aktaş, İlknur

doi:10.1007/s00586-016-4879-4

Cited by 23 publications

(13 citation statements)

References 26 publications

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“…While the exact mechanism is not understood, many studies have suggested that pain may be related to degeneration of the adjacent disc segments and facet joints due to hypermobility and increased forces at the level just cephalad to the transitional segment. 12,16,21,22 As described previously, Mahato 18 demonstrated numerous ways in which LSTV affects the load-bearing mechanics of the lumbosacral spine and contributes to mechan-ical LBP, including hypolordosis associated with L5-S1 fusion and hyperlordosis associated with L5-S1 articulation. Farshad-Amacker et al 23 demonstrated a protective effect for the disc at the transitional segment and increased degenerative changes at the adjacent cephalad disc, particularly for Castellvi-Chan types III and IV LSTV.…”

Section: Classification and Prevalencementioning

confidence: 90%

“…The prevalence of LSTV in the general population varies significantly in the literature, ranging from 4% to 35.6% in the spine literature. 2,4,8,[10][11][12][13][14][15][16] Nardo et al 14 evaluated radiographs of 4636 participants and determined the overall prevalence of LSTV to be 18.1%, with types I and II comprising nearly 80% of LST. The authors also found a significantly higher rate in men compared to women (28.1% vs 11.1%).…”

Section: Classification and Prevalencementioning

confidence: 99%

“…The relationship between LSTV and disc degeneration was further evaluated by Ahn et al, 22 who determined that patients with LSTV undergoing microdiscectomy have clinically worse outcomes compared to those with ''normal'' lumbosacral anatomy. Illeez et al 12 evaluated the relationship between LSTV and sacroiliac joint dysfunction and LBP in 700 subjects. The authors found statistically significant associations between LSTV and sacroiliac dysfunction (28.5%) and between LSTV and LBP (26%).…”

Section: Classification and Prevalencementioning

confidence: 99%

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Sacral Dysmorphism and Lumbosacral Transitional Vertebrae (LSTV) Review

et al. 2019

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Background: Anatomic variation in the relationship between the lumbar spine and sacrum was first described in the literature nearly a century ago and continues to play an important role in spine deformity, low back pain (LBP), and pelvic trauma. This review will focus on the clinical and surgical implications of abnormal lumbosacral anatomy in the context of sacroiliac joint (SIJ) disease, spine deformity, and pelvic trauma. Methods: A PubMed search using the keywords ''lumbosacral transitional vertebrae,'' ''LSTV,'' ''transitional lumbosacral vertebrae,'' ''TLSV,'' and ''sacral dysmorphism'' was performed. The articles presented here were evaluated by the authors. Clinical Significance: The prevalence of LSTV varies widely in the literature from 3.9-% to 35.6% in the spine literature, and sacral dysmorphism is described in upwards of 50% of the population in the trauma literature. The relationship between LSTV and LBP is well established. While there is no agreed-on etiology, the source of pain is multifactorial and may be related to abnormal biomechanics and alignment, disc degeneration, and arthritic changes. Surgical Implications: Understanding abnormal lumbosacral anatomy is crucial for preoperative planning of SIJ fusion, spine deformity, and pelvic trauma surgery. LSTV can alter spinopelvic parameters crucial in planning spine deformity correction. Traditional safe zones for sacroiliac screw placement do not apply in the first sacral segment in sacral dysmorphism and risk iatrogenic nerve injury. Conclusions: LSTV and sacral dysmorphism are common anatomic variants found in the general population. Abnormal lumbosacral anatomy plays a significant role in clinical evaluation of LBP and surgical planning in SIJ fusion, spine deformity, and pelvic trauma. Further studies evaluating the influence of abnormal lumbosacral anatomy on LBP and surgical technique would help guide treatment for these patients.

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Section: Classification and Prevalencementioning

confidence: 90%

Section: Classification and Prevalencementioning

confidence: 99%

Section: Classification and Prevalencementioning

confidence: 99%

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Sacral Dysmorphism and Lumbosacral Transitional Vertebrae (LSTV) Review

et al. 2019

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“…It is rare to find reports that discuss the screw insertion anatomy in the context of the variability of sacral morphology seen in transitional lumbosacral variations. 1,34,35 LSTV anatomy in the setting of sacroiliac joint instrumentations can hardly be overemphasized given the variations presented in the sacral anatomy and the vicinity of vital neurovascular structures along the trajectory of screw placement through the upper osseous corridors in the sacrum. This study presents a detailed report on quantitative assessment of LSTV-related sacral anatomy and, at the same time, identifies and compares differences in dimensions between the normal sacrum and those that are associated with lumbosacral transitional subtypes in context of sacroiliac screw insertion.…”

Section: Discussionmentioning

confidence: 99%

Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

Mahato

2020

Neurospine

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Objective: Although a wide range of sacral dysmorphisms has been documented with lumbosacral transitional vertebrae (LSTV) variations, quantitative characterization of the upper segment morphology and articular anatomy across the array of lumbosacral transitions are hardly found in the literature. This study presents LSTV anomalies as a series of sequential morphological changes (the LSTV spectrum) and quantitatively compares 6 LSTV subtypes with normative sacral dimensions including the anatomy at the upper sacral segments used for percutaneous sacroiliac screw insertion. Methods: Seven linear dimensions were measured from LSTV subtypes and normal sacral variants from dried adult sacral specimens. The auricular, superior articular and facet surface areas were quantified. Obliquity and thickness of osseous corridors used for sacroiliac screw fixation were measured. Data were statistically compared within and between LSTV subtypes and the normal variants. Results: LSTVs presented a wide range of morphometric differences in comparison to the normal bones. Grouping LSTV according to auricular surface positions (high, normal, and low) demonstrated significant between-group differences in the obliquity and thickness at the S1 and S2 segmental corridors. Conclusion: Frequent occurrence of LSTV in the general population may require evaluation of anatomical parameters in these variations for safe sacroiliac instrumentation around this region.

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“…Lumbosakral GV'nin kronik bel ağrısı, sinir kökü semptomları ve sakroiliak disfonksiyon ile ilişkili olduğu bilinmektedir (7)(8)(9)(10). Bunun yanında GV'nin belirlenmesi ve numaralandırılması özellikle cerrahi öncesi planlamada yanlış seviyelerin cerrahi girişiminden kaçınmak için çok önemlidir.…”

Section: Lumbosakral Geçiş Vertebrasının Numaralandırılmasında Paraspunclassified

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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The transitional vertebra and sacroiliac joint dysfunction association

Abstract: Sacroiliac joint dysfunction must be considered when investigating the etiology of low back pain. Particular sensitivity must be exhibited on this subject in patients with transitional vertebrae.

Cited by 23 publications

References 26 publications

Sacral Dysmorphism and Lumbosacral Transitional Vertebrae (LSTV) Review

Sacral Dysmorphism and Lumbosacral Transitional Vertebrae (LSTV) Review

Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

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

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