Prevalence of Lumbosacral Transitional Vertebral Anomalies Among Healthy Volunteers and Patients with Hip Pathology

Abstract

Background: A lumbosacral transitional vertebra (LSTV) has been reported to be prevalent among patients with hip dysplasia. The aims of this study were to determine the (1) prevalence of an LSTV in young patients presenting with hip pain and a group of asymptomatic volunteers, (2) effect of an LSTV on spinopelvic characteristics, and (3) presence of low back pain among patients with an LSTV.Methods: This cross-sectional study included 102 patients with hip pathology and 51 asymptomatic volunteers (mean age, 33.9 ± 7.3 years; mean body mass index, 26.0 ± 5.0 kg/m 2 ; 57.5% female). Participants underwent radiographic assessment of the lumbar spine and pelvis in standing and deep-seated positions. LSTV occurrence was classified according to the Castellvi system. Spinopelvic characteristics included lumbar lordosis (including segmental lumbar angles), pelvic tilt, and hip flexion (pelvic-femoral angle). Differences between standing and deep-seated values were calculated. Low back pain was assessed using the Oswestry Disability Index. Results:The prevalence of LSTV type ‡II was 8.5%, with no difference between patients and volunteers (p = 0.386).Individuals with an LSTV had a greater standing L1-L5 angle (mean, 51.6°± 11.7°versus 38.9°± 9.3°; p < 0.001). The overall spinal flexion (change in L1-S1 angle between the standing and deep-seated positions) in individuals with an LSTV was similar to that in individuals without an LSTV; restricted L5-S1 mobility was compensated for at L1-L2 (10.2°± 5.8°in those with versus 8.4°± 4.1°in those without an LSTV; p = 0.070). No significant difference in the presence of low back pain was found (p = 0.250).Conclusions: An LSTV was found in 8.5% of young adults, with no difference between patients with hip pathology and controls. Individuals with an LSTV have greater standing lumbar lordosis, with altered mechanics at the cephalad adjacent level, which may predispose these individuals to degenerative changes at this level.

The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

“…No differences in pelvic tilt were detected between patients with LSTV and control group. These findings go in line with the results reported by Verhaegen et al whom didn’t find any differences in pelvic tilt in upright standing and sitting position in a cohort of patients with LSTV compared to a control group 31 . Therefore, even if pelvic tilt is a main influencing factor of acetabular version, differences in acetabular orientation in patients with LSTV might be attributed to differences in pelvic geometry and less to differences in posture, as previously reported by Haffer et al 2 .…”