INCIDENCE OF LUMBOSACRAL TRANSITIONALVERTEBRAE (LSTV) AMONGEST THE POPULATION OF UP—A MORPHOLOGICAL STUDY ON BONES
Keywords:
Vertebrae, Sacrum, Sacralisation, Lumbarisation, Transitional vertebrae, HOX gene
Abstract
Introduction: The human vertebral column is divided into five regions viz cervical, thoracic, lumbar, sacral and coccygeal regions. The lumbar region is designed mainly to facilitate movements of the back and support the body weight. Abnormal fusion between L5 & S1 vertebrae results in Sacralisation. Lumbarization occurs when the first segment of the sacrum is not fused with rest of sacrum & remains free to move. Both these conditions are discussed under one common heading“Lumbosacral transitional vertebrae” (LSTV). The prevalence is 1-30 %. Various researchers have identified the role of LSTV in low back pain. Sacralized segment can impinge on spinal nerve roots or the cauda equina structures producing various symptoms & signs.
Aim: Knowledge of LSTV is helpful 1 to diagnose and treat patients with low back pain 2. Awareness of such congenital anomaly of the vertebral column is important before undertaking any spinal surgery.
Material & Methods: 100 dry adult sacra belonging to the dept. of anatomy SMC, Ghaziabad (UP) were used for the study. Every specimen was studied for features of: 1. Sacralization 2.Lumbarization.
Observation: LSTV was seen in 27%; four specimens showing lumbarization & 23 showing sacralization of grade IIIb (of Castellvi).
Discussion: The association between LSTV and back pain was first described in 1917 by Bertolotti. Mutations of HOX10/ HOX11 genes may play a role in the formation of LSTV. A knowledge of LSTV helps in treating low backache & diagnosis of various associated pathologies of the vertebral column.
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References
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32) Khanna, J. &Chauvan, R. Anatomical variations and clinical relevance of dorsal sacral foramina in North Indians. Int. J. Res. Med. Sci., 1(3):263-6, 2003
33) Elva G. Delport, MD, Tony R. Cucuzzella, MD, Nancy Kim, MD, Julie Marley, PT, Dip MDT, Christine Pruitt, RN, MS, and Anton G. Delport, PT, Dip MDT Lumbosacral Transitional Vertebrae: Incidence in a Consecutive Patient Series Pain Physician. 2006; 9:53-56.
34) Bron J L, van Royen B J, Wuisman P I. The clinical significance of lumbosacral transitional anomalies. Acta Orthop Belg. 2007; 73(6):687–695.
35) Lorenzo Nardo, MD, HamzaAlizai, MD, Warapat Virayavanich, MD, Felix Liu, MS, Alexandra Lumbosacral Transitional Vertebrae: Association with Low Back Pain
Radiology, Nov 2012, Vol. 265:645–646, https:
36) Deepa TK, Martin K John a study of lumbarisation of first sacral vertebra among the south Indians International Journal of Medical Research &Health Sciences 2014; 3(1): 1-4.
37) Renu Gupta, Rajnees Garg et al. Incidence of lumbarization and sacralization in normal and low backache patients-A roentgenogram study IJBR> (2014) Vol. 5, No 9
38) Jeffrey M. Jancuska, BA, 1 Jeffrey M. Spivak, MD, 2 and John A. Bendo, MD2 A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti'sSyndromeInt J Spine Surg. 2015; 9: 42.
39) Son KM, Lee SM, Lee GW, Ahn MH, Son JH. The Impact of Lumbosacral Transitional Vertebrae on Therapeutic Outcomes of Transforaminal Epidural Injection in
Patients with Lumbar Disc Herniation. Pain Pract. 2016 Jul; 16(6):688-95.
40) F. de Bruin, S. ter Horst, J. L. Bloem Prevalence and clinical significance of lumbosacral transitional vertebra (LSTV) in a young back pain population with suspected axial spondyloarthritis. Results of the SPondyloArthritis Caught Early (SPACE) cohort Skeletal Radiol (2017) pp 1–7. doi:10.1007/s00256-017-2581-1
41) Balachandar Gopalan and Janardhan Srinivas Yerramshetty Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy Asian Spine J. 2018 Jun; 12(3): 407–415.Published online 2018 Jun 4. doi: 10.4184/asj.2018.12.3.407.
2) What is Sacralization and how is it Treated? – ePain Assist https://www.epainassist.com Back Pain Low Back Pain
3) Dr. Karan BhagwanKhairnar, Dr. ManishaBhausahebRajale “SACRALIZATION OF LUMBAR VERTEBRA” Indian Journal of Basic & Applied Medical Research; March 2013: Issue-6, Vol.-2, P. 510-514
4) Joseph S. Cheng, MD; John K. Song, MD Anatomy of the SacrumNeurosurg. Focus. 2003; 15(2)
5) Sacralization of l5 vertebrae: what it is, treatment, symptoms, typesback.vsebolezni.com/deformacii.../l echenie-sakralizacii-pozvonka-l5.htm...
6) A. Prof Frank Gaillard et al.Lumbosacral transitional vertebraLumbosacral transitional vertebra |Radiology Reference Article.https://radiopaedia.org/articles/lu
mbosacral-transitional-vertebra
7) Sacralized Vertebra - Back Painwww.cure-back-pain.org/sacralizedvertebra.html
8) Lumbarisation and Sacralisation - impleBackPain.comwww.simplebackpain.com
9) Dr. Shobhakumari, Dr. Rita kumari1, Dr. Padamjeet PanchalMrs. Atulyaprasad, N.J.BrittoStudy of Sacralization of Fifth Lumber Vertebra IOSR Journal of Dental and Medical Sciences (IOSRJDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 11 Ver. I (November. 2016), PP 58-6
10) SangeetaWazir. Sacralisation of lumbar vertebrae Int J Anat Res 2014, Vol 2(2):386-89.
11) Bertolotti M. Contribute all a conoscenza deivizi di different zazionedelrachide con special areguardo all assimilazi on esacraledella v lombare. La Radiologia Medica 1917; 4:113–44
12) Jeffrey M. Jancuska, BA,1 Jeffrey M. Spivak, MD,2 John A. Bendo, MD2 A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti’s Syndrome. International Journal of Spine Surgery,2015 Volume 9 Article 42 doi: 10.14444/2042
13) Sacralization Lumbosacral Fusion - Back Painwww.cure-back-pain.org
14) Johannes L. Bron, barend J. Van royen, paul I J. M. Wuismanthe clinical significance of lumbosacral transitional anomaliesActaorthop. Belg., 2007, 73, 687-695.
15) Adibatti, M. &Asha, K. Lumbarisation of the first sacral vertebra a rare form of the lumbosacral transitional vertebra. Int. J. Morphol., 33(1):48-50, 2015.
16) Apazidis A, Ricart PA, Diefenbach CM, Spivak JM. The prevalence of transitional vertebrae in the lumbar spine. Spine J. 2011; 11: 858–862.
17) Vijay Sekharappa, RohitAmritanand, Venkates h Krishnan, and Kenny Samuel David Lumbosacral Transition Vertebra: Prevalence and Its Significance Asian
Spine J. 2014 Feb; 8(1): 51–58.
18) Juhi V. Patel, Chetan M. Mehta, Nandakishore G. Patil, Shreya R. Sehgal. Transverse sacralization of lumbar vertebrae: prevalence accordingto Castellvi classification DOI:http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164835
19) Castellvi AE, Goldstein LA, Chan DP. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine. 19845):493-5
20) Transitional Vertebrae-Lumbarization – Learning Radiology learning radiology.com/notes/bonenotes/transitionalvertebrae.htm
21) G.P. Konina and D.M. Walza Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance American Journal of Neuroradiology 2010 Nov;31(10):1778- 86.
22) Does Sacralization Cause Back Pain www.cure-back-pain.orgoes sachttps://www.cure-back-pain.org/doessacralization-cause-back-pain.html
23) Back Pain. What is Lumbarization and how can it Be Treated? - ePainAssisthttps://www.epainassist.com › Back Pain › Low Back Pain
24) Sacralization of the L5 vertebral body - Neurology - Med Help www.medhelp.org/posts/Neurology/Sacralization-of-L5-vertebral-body-/.../731643
25) Heath D. French, Arjuna J. Somasundaram,2 Nathan R. Schaefer,2 and Richard W. Laherty3Lumbosacral Transitional Vertebrae and Its Prevalence in the Australian Population, Global Spine J. 2014 Dec; 4(4): 229–232.
26) Williams, P. C. The lumbosacral spine, emphasizing conservative management. New York, McGraw-Hill Book Company, 1965. Pp.27-32, 149-50.
27) Wigh, R. E. & Anthony, H. F. Jr. Transitional lumbosacral discs. The probability of herniation. Spine (Phila Pa 1976), 6(2):168-71, 1981.
28) Meschan, I. An Atlas of Anatomy Basic to Radiology. Philadelphia, W. B. Saunders, 1985. Pp.511-2.
29) Peh W C, Siu T H, Chan J H. Determining the lumbar vertebral segments on magnetic resonance imaging. Spine ( Phila Pa 1976) 1999;24(17):1852–1855
30) M. U. Eyo A. Olofin, C. Noronha, A. Okanlawonincidence of lumbosacral transitional vertebrae in low back painpatientsWest African Journal of RadiologyApril 2001 Vol. 8 No. 1
31) Cheng, J. S. & Song, J. K. Anatomy of the sacrum. Neurosurg. Focus, 15(2):E3, 2003.
32) Khanna, J. &Chauvan, R. Anatomical variations and clinical relevance of dorsal sacral foramina in North Indians. Int. J. Res. Med. Sci., 1(3):263-6, 2003
33) Elva G. Delport, MD, Tony R. Cucuzzella, MD, Nancy Kim, MD, Julie Marley, PT, Dip MDT, Christine Pruitt, RN, MS, and Anton G. Delport, PT, Dip MDT Lumbosacral Transitional Vertebrae: Incidence in a Consecutive Patient Series Pain Physician. 2006; 9:53-56.
34) Bron J L, van Royen B J, Wuisman P I. The clinical significance of lumbosacral transitional anomalies. Acta Orthop Belg. 2007; 73(6):687–695.
35) Lorenzo Nardo, MD, HamzaAlizai, MD, Warapat Virayavanich, MD, Felix Liu, MS, Alexandra Lumbosacral Transitional Vertebrae: Association with Low Back Pain
Radiology, Nov 2012, Vol. 265:645–646, https:
36) Deepa TK, Martin K John a study of lumbarisation of first sacral vertebra among the south Indians International Journal of Medical Research &Health Sciences 2014; 3(1): 1-4.
37) Renu Gupta, Rajnees Garg et al. Incidence of lumbarization and sacralization in normal and low backache patients-A roentgenogram study IJBR> (2014) Vol. 5, No 9
38) Jeffrey M. Jancuska, BA, 1 Jeffrey M. Spivak, MD, 2 and John A. Bendo, MD2 A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti'sSyndromeInt J Spine Surg. 2015; 9: 42.
39) Son KM, Lee SM, Lee GW, Ahn MH, Son JH. The Impact of Lumbosacral Transitional Vertebrae on Therapeutic Outcomes of Transforaminal Epidural Injection in
Patients with Lumbar Disc Herniation. Pain Pract. 2016 Jul; 16(6):688-95.
40) F. de Bruin, S. ter Horst, J. L. Bloem Prevalence and clinical significance of lumbosacral transitional vertebra (LSTV) in a young back pain population with suspected axial spondyloarthritis. Results of the SPondyloArthritis Caught Early (SPACE) cohort Skeletal Radiol (2017) pp 1–7. doi:10.1007/s00256-017-2581-1
41) Balachandar Gopalan and Janardhan Srinivas Yerramshetty Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy Asian Spine J. 2018 Jun; 12(3): 407–415.Published online 2018 Jun 4. doi: 10.4184/asj.2018.12.3.407.
How to Cite
1.
Dr. Nisha Kaul. INCIDENCE OF LUMBOSACRAL TRANSITIONALVERTEBRAE (LSTV) AMONGEST THE POPULATION OF UP—A MORPHOLOGICAL STUDY ON BONES. Med. res. chronicles [Internet]. 2018Aug.31 [cited 2024Nov.25];5(4):287-04. Available from: https://medrech.com/index.php/medrech/article/view/316
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Original Research Article
