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

Abstract

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.

Reliability of coeliac and superior mesenteric artery origin level in lumbosacral transitional vertebrae detection and vertebral numbering

“…The prevalence of LSTV in the literature is reported between 4% and 37%. The systematic evaluation of some studies conducted between 2000 and 2020 found a mean LSTV prevalence of 19.4% [6][7][8][9][10][11][12][13][14][15][16][17][18]. LSTV was detected in 18.3% of 972 cases in our study.…”

Definition of normal vertebral morphology using NHANES-II radiographs

“…Spines with <> 5 lumbar vertebrae are uncommon (71) . Transitional vertebrae may be more common (72) , but it is unclear whether this would consistently compromise labeling from a lateral spine x-ray. The assumption is that the vertebrae were correctly labeled in the majority of cases and the possibility of mislabeled vertebrae in a minority of cases would not significantly affect the results.…”

Functional outcomes are preserved in adult acetabular dysplasia with radiographic evidence of lumbosacral spine anomalies: an investigation in hip-spine syndrome

“…The two musculoskeletal radiologists identified 45 (33%) hips with lumbosacral transitional vertebrae, which were classified according to the Castellvi type classification [ 34 ]. Castellvi type 3B with bilateral fusion of the transverse process and sacrum was the most frequently identified variant determined by both readers, followed by 2A [ 16 ].…”