Lumbosacral Transitional Vertebrae and Their Relationship With Lumbar Extradural Defects

Castellvi, Antonio E.; Goldstein, Louis A.; Chan, Donald

doi:10.1097/00007632-198407000-00014

Cited by 452 publications

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“…According to Castellvi’s classification, there are four types of lumbosacral transitional vertebrae, type I, dysplastic transverse process with height > 90 mm, type II, incomplete lumbarisation/sacralisation, type III, complete lumbarisation/sacralisation with complete fusion with the neighboring sacral basis and type IV, mixed [2]. …”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that the lumbosacral transitional vertebra decreases the annulus fibrosis degeneration of the disc below, without having the same effect on endplates and nuclear complex [5]. An association has been found between lumbosacral transitional vertebra and disc herniations as well as facet joint degeneration [2,4]. Otani et al stated that a lumbosacral transitional vertebra was found more often in patients with disc herniation (17%) than in the control group (11%) [10].…”

Section: Discussionmentioning

confidence: 99%

“…According to Castellvi et al the transitional vertebrae cause abnormal torque movements above these anomalous vertebrae, a fact that could result in disc degeneration [2]. Aihara et al in an anatomical study of 70 cadavers claimed that the iliolumbar ligament at the level immediately above the transitional vertebra is much thinner and weaker than in cadavers without a lumbosacral transitional vertebra.…”

Section: Discussionmentioning

confidence: 99%

“…“Bertolotti’s syndrome” is characterised by the presence of a variation of the fifth lumbar vertebra having a large transverse process, either articulated or fused with the sacral basis or iliac crest, and producing a chronic, persistent low back pain [1,2]. Bertolotti stated as early as in 1917 that these abnormal vertebrae may produce low back pain due to arthritic changes occurring at the site of pseudarthrosis [3].…”

Section: Introductionmentioning

confidence: 99%

“…Bertolotti stated as early as in 1917 that these abnormal vertebrae may produce low back pain due to arthritic changes occurring at the site of pseudarthrosis [3]. That not rare anatomic variant is reported as having an incidence of 4% to 21% [2,4]. Recently, a very high incidence of 30% has been reported [5].…”

Section: Introductionmentioning

confidence: 99%

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Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature

Paraskevas¹,

Tzaveas²,

Koutras³

et al. 2009

Cases J

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IntroductionLumbosacral transitional vertebra is an anatomical variation of the fifth lumbar vertebra in which an enlarged transverse process can form a joint or fusion with the sacrum or ilium. The association of that variant with low back pain and the change in the biomechanical properties of the lumbar spine is called Bertolotti’s syndrome.Case presentationWe report a case of a 40-year-old male patient with chronic low back pain extending to the left buttock, just above the ipsilateral sacroiliac joint. Radiographic investigation revealed an anomalous enlargement of the left transverse process of the fifth lumbar vertebra forming a pseudarthrosis with the infrajacent ala of the sacrum.ConclusionIn young patients with back pain the possibility of Bertolotti’s syndrome should always be taken in account.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature

Paraskevas¹,

Tzaveas²,

Koutras³

et al. 2009

Cases J

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Lumbar Vertebrae

Dawkins¹,

Hadley²

2016

Bergman's Comprehensive Encyclopedia of Human Anatomic Variation

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The morphological consequences of segmentation anomalies in the human sacrum

Krenn

Fornai

Webb

et al. 2021

American Journal of Biological Anthropology

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Objectives Despite the high frequency of segmentation anomalies in the human sacrum, their evolutionary and clinical implications remain controversial. Specifically, inconsistencies involving the classification and counting methods obscure accurate assessment of lumbosacral transitional vertebrae. Therefore, we aim to establish more reliable morphological and morphometric methods for differentiating between sacralizations and lumbarizations in clinical and paleontological contexts. Materials and Methods Using clinical CT data from 145 individuals aged 14–47 years, vertebral counts and the spatial relationship between the sacrum and adjoining bony structures were assessed, while the morphological variation of the sacrum was assessed using geometric morphometrics based on varied landmark configurations. Results The prevalence of lumbosacral and sacrococcygeal segmentation anomalies was 40%. Lumbarizations and sacralizations were reliably distinguishable based on the spatial relationship between the iliac crest and the upward or downward trajectory of the linea terminalis on the sacrum. Different craniocaudal orientations of the alae relative to the corpus of the first sacral vertebra were also reflected in the geometric morphometric analyses. The fusion of the coccyx (32%) was frequently coupled with lumbarizations, suggesting that the six‐element sacra more often incorporate the coccyx rather than the fifth lumbar vertebra. Conclusions Our approach allowed the consistent identification of segmentation anomalies even in isolated sacra. Additionally, our outcomes either suggest that homeotic border shifts often affect multiple spinal regions in a unidirectional way, or that sacrum length is highly conserved perhaps due to functional constraints. Our results elucidate the potential clinical, biomechanical, and evolutionary significance of lumbosacral transitional vertebrae.

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Lumbosacral Transitional Vertebrae and Their Relationship With Lumbar Extradural Defects

Cited by 452 publications

References 0 publications

Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature

Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature

Lumbar Vertebrae

The morphological consequences of segmentation anomalies in the human sacrum

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