Increased vertebral body area, disc and facet joint degeneration throughout the lumbar spine in patients with lumbosacral transitional vertebrae

Griffith, James F.; Fan, Xiaoxi; Hilkens, Andrea; Griffith, Isobel Han Ying; Leung, Jason

doi:10.1007/s00330-022-08736-0

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…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). In this study, the small sample size limits our further analysis of LSTV.…”

Section: Discussionmentioning

confidence: 86%

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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Section: Discussionmentioning

confidence: 86%

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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“…So far, many studies have evaluated the relationship between the presence of LSTV, especially sacralization, in spondylolisthesis and its clinical features. While some studies confirm the association of LSTV with an increased risk of degenerative changes over the transitional vertebra [ 23 – 26 ], conflicting findings also exist. For instance, Kong et al reported no difference in the degree of anterior slippage and disc degeneration between patients with and without L5 sacralization in a sample of patients with degenerative spondylolisthesis [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Lumbosacral transitional vertebra in spondylolisthesis: frequency, demographic findings, and clinical characteristics

Mahmoodkhani,

Naeimi,

Zohrevand

et al. 2024

BMC Musculoskelet Disord

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Background The association of LSTV with low back pain has been debated in the literature for nearly a century, but the relationship between LSTV and spondylolisthesis is still under discussion. There is currently no valid information about LSTV’s prevalence in Iran. This study investigated the relationship between the presence of LSTV and lumbosacral spondylolisthesis regarding frequency, gender and age variation, grade and level of spondylolisthesis, and clinical signs and symptoms. Methods This cross-sectional study included spondylolisthesis patients admitted for surgery between March 2021 to December 2022. All patients underwent CT imaging. After evaluating medical records, the baseline data were collected. Patients were categorized into No LSTV, Sacralization, and Lumbarization groups. Demographic and clinical characteristics of the studied groups were compared using an independent T-test and Chi-Square. Multiple logistic regression was used to assess the age and sex variations between groups. Results 219 patients with a mean age of 57.07 ± 11.04 were included. A significant relationship was observed between the presence of sacralization and gender diversity with female predominance (P = 0.01). The level of spondylolisthesis and the presence of motor deficits (paresis) significantly differed among study groups (P < 0.05). Sacralization group exhibited a greater prevalence of higher grades of listhesis compared to the other groups. Conclusions LSTV is frequently seen in spondylolisthesis patients. Sacralization is the common type of LSTV in spondylolisthesis patients, possibly leading to an increased risk for higher grades of vertebral slip and higher rates of motor deficit signs and symptoms. The presence of sacralization results in a significant increase in the incidence of higher levels of spondylolisthesis, especially the L4-L5*(sacralized L5) level. There is no relationship between age and the presence of LSTV in spondylolisthesis.

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“…36 The effect of LSTV on the adjacent disc is considered to be similar with the consequences of a fusion operation in which mobility at intervertebral disc space(s) is restricted in relation to other disc levels. 37 Although there are studies confirming the association of LSTV with increased risk of degenerative changes over the transitional vertebra, 12,[37][38][39][40] there are conflicting studies, as well. Kong et al found no difference in the degree of anterior slippage and disc degeneration between patients with and without L5 sacralization in a sample of patients with degenerative spondylolisthesis.…”

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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Increased vertebral body area, disc and facet joint degeneration throughout the lumbar spine in patients with lumbosacral transitional vertebrae

Cited by 10 publications

References 14 publications

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

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

Lumbosacral transitional vertebra in spondylolisthesis: frequency, demographic findings, and clinical characteristics

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

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