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1
Proks, Pavel, Trude Maria Johansen, Ivana Nývltová, Dominik Komenda, Hana Černochová, and Massimo Vignoli. "Vertebral Formulae and Congenital Vertebral Anomalies in Guinea Pigs: A Retrospective Radiographic Study." Animals 11, no. 3 (2021): 589. http://dx.doi.org/10.3390/ani11030589.
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The objectives of this retrospective study of 240 guinea pigs (148 females and 92 males) were to determine the prevalence of different vertebral formulae and the type and anatomical localization of congenital vertebral anomalies (CVA). Radiographs of the cervical (C), thoracic (Th), lumbar (L), sacral (S), and caudal (Cd) part of the vertebral column were reviewed. Morphology and number of vertebrae in each segment of the vertebral column and type and localization of CVA were recorded. In 210/240 guinea pigs (87.50%) with normal vertebral morphology, nine vertebral formulae were found with constant number of C but variable number of Th, L, and S vertebrae: C7/Th13/L6/S4/Cd5-7 (75%), C7/Th13/L6/S3/Cd6-7 (4.17%), C7/Th13/L5/S4/Cd6-7 (2.50%), C7/Th13/L6/S5/Cd5-6 (1.67%), C7/Th12/L6/S4/Cd6 (1.25%), C7/Th13/L7/S4/Cd6 (1.25%), C7/Th13/L7/S3/Cd6-7 (0.83%), C7/Th12/L7/S4/Cd5 (0.42%), C7/Th13/L5/S5/Cd7 (0.42%). CVA were found in 30/240 (12.5%) of guinea pigs, mostly as a transitional vertebra (28/30), which represents 100% of single CVA localised in cervicothoracic (n = 1), thoracolumbar (n = 22) and lumbosacral segments (n = 5). Five morphological variants of thoracolumbar transitional vertebrae (TTV) were identified. Two (2/30) guinea pigs had a combination of CVA: cervical block vertebra and TTV (n = 1) and TTV and lumbosacral transitional vertebra (LTV) (n = 1). These findings suggest that guinea pigs’ vertebral column displays more morphological variants with occasional CVA predominantly transitional vertebrae.
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Paraskevas, George, Maria Tzika, and Panagiotis Kitsoulis. "LUMBOSACRAL TRANSITIONAL VERTEBRA ASSOCIATED WITH SACRAL SPINA BIFIDA OCCULTA: A CASE REPORT." Acta Medica (Hradec Kralove, Czech Republic) 56, no. 3 (2013): 126–29. http://dx.doi.org/10.14712/18059694.2014.21.
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Congenital malformations such as lumbosacral transitional vertebrae and spina bifida occulta constitute unrare anomalies and could affect the symptomatology of low back pain. A transitional vertebra is characterized by elongation of one or both transverse processes, leading to the appearance of a sacralized fifth lumbar vertebra or a lumbarized first sacral vertebra. Furthermore, sacral spina bifida occulta is a developmental anomaly that corresponds to the incomplete closure of the vertebral column. In the present case report, we describe a case of a dried sacrum presenting a partially sacralized fifth lumbar vertebra and total spina bifida, extended from first to fifth sacral vertebra. A pseudoarthrosis is formed on the left side and the specimen could be incorporated in Castellvi’s type IIa. Moreover, the incidence, morphology, clinical and surgical significance of these spinal malformations are discussed.
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Sabri, Shahbaaz A., Renzo A. Laynes, Clayton J. Hoffman, et al. "Implications of lumbosacral transitional anatomy on vertebral numbering: evaluation of 3147 adult full-length spine radiographs." Neurosurgical Focus 58, no. 6 (2025): E13. https://doi.org/10.3171/2025.3.focus2555.
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OBJECTIVE When evaluating anomalous vertebral anatomy, limited consensus exists on how to best label vertebrae, leading to numbering discrepancies between radiologists and surgeons. Errors in vertebral numbering can have devastating implications for patients, especially when intraoperative numbering errors occur. Analyzing whole-spine radiographs and identifying patterns of transitional anatomy relative to vertebral numbering could allow for a consistent numbering method. METHODS This single-institution cross-sectional study included patients older than 18 years of age who underwent full-length spine imaging at the University of Colorado Hospital from January 31, 2018, to March 31, 2020. Patients with deformity or congenital fusion were included. A retrospective analysis was performed on full-length spine radiographs obtained in 3147 patients. The number of presacral mobile segments, number of ribs, and presence of hypoplastic or incomplete ribs were identified and recorded. Results were reviewed by a committee of musculoskeletal radiologists, neurosurgeons, and orthopedic spine surgeons, with verification through interobserver analysis. RESULTS Among 3147 patients (age range 18–89 years), 2868 (91.1%) had the conventional 24 presacral mobile segments (7 cervical, 12 thoracic, 5 lumbar). Transitional anatomy, defined as having fewer or more than 24 presacral segments, was observed in 279 patients (8.8%). Specifically, 174 patients (5.5%) had 25 presacral segments, 104 patients (3.3%) had 23, and 1 patient (0.03%) had 26. Regarding the number of ribbed vertebrae (thoracic), 2976 patients (94.6%) had 12 ribs, including hypoplastic ribs, while 143 (4.5%) had 11 ribs, and 28 (0.88%) had 13 ribs. The co-occurrence of both lumbosacral transitional anatomy and an abnormal number of ribbed vertebrae (thoracic) was least prevalent and observed in 56 patients (1.8%). Considering the first nonribbed vertebra as the first lumbar vertebra aligned with the most prevalent pattern of transitional anatomy. CONCLUSIONS Evaluation of 3147 patients with full-length spine imaging demonstrated a lower prevalence of ribbed vertebral body anatomical variations compared with transitional lumbosacral anatomy. Based on these findings, the authors suggest further investigation of numbering vertebrae in a cranial to caudal progression, designating the first ribbed vertebra as thoracic (T1) and the first nonribbed vertebra in the lumbar spine as lumbar (L1). The clinical impact of a standardized vertebral numbering system is yet to be determined.
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Fialová, Iva, Michaela Paninárová, Alois Nečas, Ladislav Stehlík, and Pavel Proks. "Prevalence of lumbosacral transitional vertebrae in dogs in the Czech Republic." Acta Veterinaria Brno 83, no. 4 (2014): 399–403. http://dx.doi.org/10.2754/avb201483040399.
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Lumbosacral transitional vertebra is a common congenital anomaly of the spine in dogs. It is a predisposing factor for degeneration of the lumbosacral spine and development of cauda equina syndrome or hip dysplasia in affected dogs. The aim of the study was to determine breed predisposition, types, and prevalence of lumbosacral transitional vertebrae in the canine population in the Czech Republic. The value of laterolateral radiographs of the lumbosacral junction in the diagnosis of LTV was also evaluated. Prevalence of lumbosacral transitional vertebrae was determined by reviewing ventrodorsal radiographs of pelvis with an extended hip of 1,878 dogs. Lumbosacral transitional vertebrae were detected in 188 dogs (10%). German Shepherd, Alaskan Malamute and Bohemian Shepherd were found to be highly predisposed breeds. The most common type of lumbosacral transitional vertebra was type II with separation of the first sacral vertebra from sacrum and presence of rudimentary intervertebral space between S1 and the sacral median crest (37.8% of the lumbosacral transitional vertebrae). Type I was detected in 29.2% and the asymmetric type of the lumbosacral transitional vertebra (type III) in 33%. Laterolateral radiograph of the lumbosacral spine was evaluated in 126 dogs from 188 with lumbosacral transitional vertebrae. Rudimentary intervertebral disc space between S1 and S2 in laterolateral radiographs was detected in 100% of lumbosacral transitional vertebrae with type II and III, and was not detected in type I. The findings on lumbosacral transitional vertebrae in the Czech Republic will extend knowledge about the disease. Both ventrodorsal hip-extended and laterolateral radiographs should be recommended for routine screening and reliable differentiation among the three different types of lumbosacral transitional vertebra.
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Paninárová, Michaela, Ladislav Stehlík, Pavel Proks, and Massimo Vignoli. "Congenital and acquired anomalies of the caudal vertebrae in dogs: Radiographic classification and prevalence evaluation." Acta Veterinaria Hungarica 64, no. 3 (2016): 330–39. http://dx.doi.org/10.1556/004.2016.031.
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A prospective study to create radiographic classification of caudal vertebral anomalies in dogs was performed and the prevalence of the disorders estimated. Radiographic examination of the caudal vertebrae was performed in 595 client-owned dogs undergoing routine radiological examination of the hip joints. Anomalies of the caudal vertebrae were divided into four groups: (1) congenital anomalies with aberrant fusion of the vertebral epiphysis, like hemivertebra, block or transitional vertebra; (2) morphological anomalies like vertebra curva and dysplastic vertebral epiphysis; (3) post-traumatic changes, represented by fracture or luxation; and (4) degenerative changes, represented by spondylosis, osteophyte formation and mineralisation of intervertebral spaces. A total of 303 caudal vertebral anomalies were detected in 259 dogs (43.53% of all dogs examined). A single type of vertebral anomaly was present in 215 dogs and a combination of two pathologies was recorded in 44 dogs, which represents 83.01% and 16.99%, respectively, of the affected dogs. Congenital anomaly was present in 11.09% of the dogs examined. Sacrocaudal transitional vertebra was the most common congenital anomaly, present in 12.74% of the affected dogs. Radiographic examination of the caudal vertebrae is recommended as an essential part of any screening process to confirm the presence of congenital anomaly as a cause of kinked tail.
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Khan, Sara, Adil Qayyum, Nazia Dildar, Asma Jabeen, Salahuddin Baloch, and Ruquiyya Adil. "Role of L5 Nerve Root Morphology in Identification of Lumbosacral Transitional Vertebra. Is it a Reliable Indicator?" Pakistan Armed Forces Medical Journal 74, no. 5 (2024): 1445–50. http://dx.doi.org/10.51253/pafmj.v74i5.4340.
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Objective: To determine whether L5 nerve root morphology can assist in identification Lumbosacral Transitional vertebra. Study Design: Cross sectional study. Place and Duration of Study: Radiology Department, Combined Military Hospital, Multan Pakistan, Apr 2019 to Apr 2020. Methodology: Patients of both genders, 15 to 50 years age who underwent whole spine MRI were included in the study. Patients were referred from Combined Military Hospital Multan, from neighboring Combined Military Hospitals and Civil. Sagittal and axial T1WS and T2WS were performed along with coronal T2WS/FS sequences. Axial images were assessed for identification of L5 nerve root arising from LV5-SV1 level and hence vertebra was identified as LV5. Correlation was done with sagittal images for presence of Transitional vertebra, further confirmed by counting vertebral bodies from C2 vertebra upto sacrum using cross referencing tool. Results: A total of 135 patients were included in the study. Out of these, transitional vertebra was confidently labeled in 23 patients by nerve identification method which was confirmed on vertebral counting method. However, in four patients, L5 nerve root morphology was not clear and we had to rely on vertebral counting method for identification of transitional vertebra. Conclusion: Neuroanatomy and morphology of exiting L5 nerve roots can act as a reliable method for numbering of lumbosacral vertebra and identification of transitional vertebra.
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HIZAL, Mustafa, and Halil GÖKKUŞ. "LLUMBOSAKRAL TRANSİZYONEL VERTEBRA: END PLATE DEJENERASYONUNU HIZLANDIRIR MI ?" Kocatepe Tıp Dergisi 23, no. 3 (2022): 276–82. http://dx.doi.org/10.18229/kocatepetip.919901.
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OBJECTIVE: Lumbosacral transitional vertebra (LSTV) which is one of the most common congenital abnormalities of lumbosacral junction is usually detected incidentally. LSTV may increase the motion above transitional segment and be associated with early degeneration. Degeneration of lumbar spine may be a result of normal aging, as well as a pathological process that affects nucleus pulposus and vertebral end plates, which is called intervertebral osteochondrosis. The aim of this study is to evaluate the association between intervertebral osteochondrosis and lumbosacral transitional vertebra.MATERIAL AND METHODS: We included 492 patients into the study and divided them into two groups depending on presence of LSTV. Patients without LSTV were counted as the control group. Patients in LSTV group was also classified into two groups as sacralized and lumbarized depending on the level of transitional vertebra. We noted the presence of spondylolisthesis, osteochondrosis, Modic signal changes, low back pain and nerve root symptoms in all groups. We compared osteochondrosis prevalences at one level above from transitional vertebrae to the same levels in patients without transitional vertebrae. We compared age distribution and frequency of sypmtoms in two groups.RESULTS: We detected Modic type 2 signal changes and intervertebral osteochondrosis more common in LSTV group (42.7% vs 28.7% and 67.1% vs. 38.3%, p<0.05). Intervertebral osteochondrosis prevelance at L4-5 in sacralized patients (52.7%), and at L5-S1 in lumbarized patients (63%) was found significantly higher than other levels and the same levels in control group (21.4% and 24.6%). Patients with low back pain were more common in the LSTV group and were seen at younger age (p <0.05).CONCLUSIONS: As a result of our study, we found that LSTV is associated with intervertebral osteochondrosis and Modic type 2 changes. Patients with transitional vertebrae tend to present with lower back pain at an earlier age due to abnormal load transfer in the vertebral column.
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Karki, Subindra, Ramchandra Paudel, Arun Phuyal, and Anupam Bhandari. "Lumbosacral Transitional Vertebrae amongst the Individuals Undergoing Magnetic Resonance Imaging of the Whole Spine in a Tertiary Care Hospital: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 59, no. 242 (2021): 839–42. http://dx.doi.org/10.31729/jnma.6336.
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Introduction: Lumbosacral transitional vertebrae is a common congenital anomalous condition of the spine. Recent advances in magnetic resonance imaging have made it possible to acquire images of the whole spine. This study aimed to find out the prevalence of lumbosacral transitional vertebrae amongst the individuals undergoing magnetic resonance imaging of the whole spine in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in 750 patients of all age groups who underwent magnetic resonance imaging of the whole spine in the Department of Radiodiagnosis and Imaging, Kathmandu University School of Medical Sciences from 7th November, 2019 to 6th November, 2020. Convenience sampling technique was used. Ethical approval was taken from the Institutional Review Committee (Reference number 207/19). Data was analysed using Statistical Package for Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. Results: Lumbosacral transitional vertebra was seen in 98 (13.10%) (95% Confidence Interval= 10.61-15.51) of the total 750 individuals. Out of the 98 patients who had lumbosacral transitional vertebra, 31 (4.10%) had lumbarization of S1 vertebra and 67 (8.94%) had sacralization of L5 vertebra. Conclusions: Prevalence of lumbosacral transitional vertebrae amongst the individuals undergoing magnetic resonance imaging of the whole spine in our hospital was similar to other study done in similar settings. Lumbosacral transitional vertebrae are a common congenital anomalous condition of the spine that is identified incidentally. Enumeration of vertebrae from the first cervical vertebra using whole spine magnetic resonance imaging can confirm the presence of the lumbosacral transitional vertebrae with much accuracy.
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Liebrand, Bart, Koen Brakel, Arthur Boon, Walter van der Weegen, Selina van der Wal, and Kris CP Vissers. "Diagnostic treatment-level discrepancies in patients with lumbosacral radicular pain and lumbar spine anomalies." Regional Anesthesia & Pain Medicine 47, no. 3 (2021): 177–82. http://dx.doi.org/10.1136/rapm-2021-103174.
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BackgroundLumbosacral transitional vertebra can result in an anomalous number of lumbar vertebrae associated with wrong level treatment. The primary aim of this study was to characterize discrepancies between reported referring levels and levels from MRI reports with treated levels. The secondary aim was to analyze interobserver variability between a pain physician and a radiologist when determining levels and classifying lumbosacral transitional vertebrae.MethodsBetween February 2016 and October 2019, a retrospective case series of prospectively collected data of the affected levels mentioned in referrals, MRI reports and treated levels was performed. The counting process, level determination, classification of lumbosacral transitional vertebrae and a secondary control were carried out by independent researchers using a standard methodology.ResultsOf the 2443 referrals, 143 patients had an anomalous number of lumbar vertebrae; of these, 114 were included for analysis. The vertebral level noted in the patient’s file, in the referral, and the reported level of treatment differed in 40% of these cases. The vertebral level between the MRI reports and treatment differed in 46% of cases. The interobserver reliability (radiologist vs pain physician) for classifying a transitional vertebra was fair ((κ=0.40) and was substantial (κ=0.70) when counting the vertebrae.ConclusionIn the presence of lumbar spine anomalies, we report a high prevalence of discrepancies between referral levels and MRI pathological findings with treatment levels. Further research is needed to better understand clinical implications.
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De Rycke, L., and J. H. Saunders. "Congenital anomalies of the vertebrae in dogs." Vlaams Diergeneeskundig Tijdschrift 86, no. 2 (2017): 105–18. http://dx.doi.org/10.21825/vdt.v86i2.16296.
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In this review article, a overview is given of the congenital pathologies of vertebrae in the dog. These pathologies are common in dogs and can be divided in two major groups: neural tube defects or spinal dysraphism, such as spina bifida with or without meningocoele and dermal sinus tract, and congenital anomalies of the vertebral column. The latter group can be subdivided in malformations originating in the embryonic period of development, such as butterfly vertebra, mediolateral wedged vertebra and transitional vertebra, or in the foetal period, such as block vertebra and dorsoventral wedged vertebra. Congenital vertebral anomalies can be incidental findings on radiographs or CT, but sometimes they can be the underlying cause of a clinical, mostly neurological problem. Due to pressure on the spinal cord, symptoms, such as pelvic limb ataxia, paresis, loss of spinal reflexes, incontinence and atrophy of the pelvic limbs may occur.
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Kabak, S. L., V. V. Zatochnaya, and N. O. Zhizhko-Mikhasevich. "Congenital anomalies of the lumbosacral spine." Proceedings of the National Academy of Sciences of Belarus, Medical series 17, no. 4 (2020): 401–8. http://dx.doi.org/10.29235/1814-6023-2020-17-4-401-408.
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The aim of the study is to compare the structure of the lumbosacral transitional vertebra, which were detected by computed tomography (CT) and identified on dried human sacral, and to discuss possible pathogenetic mechanisms of this congenital malformation. The article presents 9 cases of lumbosacral transitional vertebra, including 6 cases of L5 sacralization and 3 cases of S1 lumbarization. The formation of the transitional lumbosacral vertebra is genetically determined. All types of such developmental anomaly can be detected only on CT. L5 sacralization repeats the process of fusion of the sacral vertebra into a single bone. A lack of the costotransverse bars of the first sacral vertebrae fusion results in the S1 lumbarization.
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Kershenovich, Amir, Oscar Malo Macias, Faiz Syed, Caitlin Davenport, Gregory J. Moore, and Joseph H. Lock. "Conus Medullaris Level in Vertebral Columns With Lumbosacral Transitional Vertebra." Neurosurgery 78, no. 1 (2014): 62–70. http://dx.doi.org/10.1227/neu.0000000000001001.
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Abstract BACKGROUND: The estimated prevalence of lumbar or sacral transitional vertebrae (LSTV) in the population is 4% to 30%. Few small patient series have studied the normal level of the conus medullaris (CM) in individuals with LSTV. OBJECTIVE: To determine, by using a large cohort of patients, whether individuals of all ages with LSTV have different CM positions in the spinal canal in comparison with the rest of the population with normal vertebral columns. METHODS: We performed an institutional retrospective analysis of spinal magnetic resonance images on individuals with LSTV of all ages, sexes, and pathologies during a 10-year period. Fifty-seven percent of patients (n = 467) had a lumbarized vertebra and 43% had sacralized vertebra (n = 355). Mean age at the time of the study was 55 ± 19 years (range 1-97 years). Fifty-two percent were male and 48% were female. Sixty percent of subjects with a sacralized vertebra were female, and 54.5% of those with a lumbarized vertebra were male (P = .001). RESULTS: The CM in individuals with a lumbarized vertebra was seen to be lower at L1-2 to L2s, than un those with a sacralized vertebra where most conuses were at T12-L1 to L1s (P ⩽ 0.001). The CM level was similarly distributed among sexes and ages. CONCLUSION: In our series, the CM level, when lumbarization occurred, was lower, with a mean level at L1-L2, whereas a more superior mean level at T12-L1 was seen when sacralization occurred. CM level was not influenced by sex, age, or pathology other than tethered cords.
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DZIERZĘCKA, MAŁGORZATA, SŁAWOMIR PAŚKO, IZA WADOWSKA, TOMASZ KOWALUK, IWONA ŁUSZCZEWSKA-SIERAKOWSKA, and ANNA CHARUTA. "Relation between defects in the lumbar spine and the position and dimensions of individual vertebrae in German Shepherds." Medycyna Weterynaryjna 79, no. 09 (2023): 6792–2023. http://dx.doi.org/10.21521/mw.6792.
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The German Shepherd is among the breeds most prone to pathologies of the lumbosacral spine. The aim of the study was to examine how the presence of spine pathology affects the shape of the lumbar spine and dimensions of individual vertebrae. Mathematical analysis consisted of three measurements for each lumbar vertebra. Based on the analysis, it was concluded that there was a correlation between the height of the first five vertebrae and the occurrence of the lumbosacral transitional vertebra (LTV). It was also shown that spondylosis manifested most often with a change in the distance between individual lumbar vertebrae. There was no correlation between the incidence of spondylosis and the height of the vertebral canal. In conclusion, the presence of a LTV significantly changes the dimensions of other vertebrae in the lumbar spine, which can lead to other pathological changes in the vertebral column.
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Basel, Suman Kumar, Ram Krishna Barakoti, Rajesh Kumar Chaudhary, Babu Kaji Shrestha, Deepak Kaucha, and Sanjib Rijal. "Lumbosacral Transitional Vertebra among Patients Visiting the Department of Orthopaedics in a Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 61, no. 258 (2023): 102–5. http://dx.doi.org/10.31729/jnma.8011.
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Introduction: Lumbosacral transitional vertebra is a normal anatomical variant at the L5-S1 junction with an incidence as high as 4-36%. This alteration results in incorrect identification of vertebral segments leading to wrong surgery. The aim of the study was to find out the prevalence of lumbosacral transitional vertebra among patients visiting the department of orthopaedics in a tertiary care centre.
 Methods: A descriptive cross-sectional study was conducted from 11 September 2021 to 31 May 2022, after receiving ethical clearance from the Institutional Review Committee (Reference number: IRC-2021-9-10-09). The patients with plain radiographs of the lumbosacral spine (anteroposterior view) were assessed and evaluated by a fellow and consultant of the orthopaedic spine and classified as per Castellvi's radiographic classification. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
 Results: Among 1002 patients, lumbosacral transitional vertebra was detected in 95 (9.48%) patients (9.40-9.56, 95% Confidence Interval). Out of 95 (9.48%), patients with the lumbosacral transitional vertebra, 67 (70.53%) had sacralisation and 28 (29.47%) had lumbarization. The mean age of the patients at the time of the study included in the study was 41.6±15.12 years (range 18-85 years). The lumbosacral transitional vertebra was more common in females than males. According to the Castellvi classification, type IIa was the most common type 47 (49.47%).
 Conclusions: The prevalence of lumbosacral transitional vertebra was similar to other studies done in similar settings.
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Slijepčević, Maja, Frietson Galis, Jan W. Arntzen, and Ana Ivanović. "Homeotic transformations and number changes in the vertebral column ofTriturusnewts." PeerJ 3 (November 10, 2015): e1397. http://dx.doi.org/10.7717/peerj.1397.
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We explored intraspecific variation in vertebral formulae, more specifically the variation in the number of thoracic vertebrae and frequencies of transitional sacral vertebrae inTriturusnewts (Caudata: Salamandridae). Within salamandrid salamanders this monophyletic group shows the highest disparity in the number of thoracic vertebrae and considerable intraspecific variation in the number of thoracic vertebrae.Triturusspecies also differ in their ecological preferences, from predominantly terrestrial to largely aquatic. Following Geoffroy St. Hilaire’s and Darwin’s rule which states that structures with a large number of serially homologous repetitive elements are more variable than structures with smaller numbers, we hypothesized that the variation in vertebral formulae increases in more elongated species with a larger number of thoracic vertebrae. We furthermore hypothesized that the frequency of transitional vertebrae will be correlated with the variation in the number of thoracic vertebrae within the species. We also investigated potential effects of species hybridization on the vertebral formula. The proportion of individuals with a number of thoracic vertebrae different from the modal number and the range of variation in number of vertebrae significantly increased in species with a larger number of thoracic vertebrae. Contrary to our expectation, the frequencies of transitional vertebrae were not correlated with frequencies of change in the complete vertebrae number. The frequency of transitional sacral vertebra in hybrids did not significantly differ from that of the parental species. Such a pattern could be a result of selection pressure against transitional vertebrae and/or a bias towards the development of full vertebrae numbers. Although our data indicate relaxed selection for vertebral count changes in more elongated, aquatic species, more data on different selective pressures in species with different numbers of vertebrae in the two contrasting, terrestrial and aquatic environments are needed to test for causality.
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Luoma, Katariina, Tapio Vehmas, Raili Raininko, Ritva Luukkonen, and Hilkka Riihimäki. "Lumbosacral Transitional Vertebra." Spine 29, no. 2 (2004): 200–205. http://dx.doi.org/10.1097/01.brs.0000107223.02346.a8.
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Patel, Juhi V., Chetan M. Mehta, Nandakishore G. Patil, and Shreya R. Sehgal. "Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification." International Journal of Research in Orthopaedics 3, no. 1 (2016): 116. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20164835.
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<p class="abstract"><strong>Background:</strong> Sacralization of L5 is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both. This fusion can occur in one or both sides of the body. Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter-vertebral disc between them may be narrow. Sacralization of lumbar vertebra may be asymptomatic but is not always clinically insignificant. While sacralization may not affect at all, it can cause problems in some cases. Sacralization may be at times associated with problems in biomechanics and affect the ways of movement and posture control. Sacralization may also be an important consideration in disc surgeries. This study has been carried out to find out prevalence of sacralisation of transverse process of fifth lumbar vertebrae<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> The present study of transverse sacralisation of fifth lumbar vertebra was carried out on 35 randomly selected patients. The sample consisted of patients undergoing CT scan for abdominal complains. Bone window of all patients were evaluated to look for lumbosacral transitional vertebra.<strong></strong></p><p class="abstract"><strong>Results:</strong> The prevalence of transverse sacralization of lumbar vertebra turned out to be 25.7% out of which Castellvi type IIb was found to be most common, accounting for 33.3% cases. 5.7% comprised the group of normal variant (Castellvi’s type I) and 68.6% were normal<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span>It is important to determine lumbosacral transitional vertebra as it can affect spinal movement and put excess stress on the lumbar vertebrae and in between disc. Moreover it</span> can have a bearing on counting of vertebral levels specially during planning of spinal surgey<span lang="EN-IN">.</span></p><p> </p>
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Bhattarai, Manoj. "A hospital based plain radiographic observational study of lumbosacral transitional vertebrae in the Nepalese population." Asian Journal of Medical Sciences 9, no. 4 (2018): 46–50. http://dx.doi.org/10.3126/ajms.v9i4.19725.
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Background: Presence of lumbosacral transitional vertebra may lead to number of clinical consequences because of failure to correctly number the problematic vertebra and also has been associated with low back pain. Different studies done at different part of the world have shown wide range of prevalence of lumbosacral transitional vertebra.Aims and Objective: This hospital based cross sectional observational study was undertaken to determine the prevalence of lumbosacral transitional vertebra among the Nepalese population.Materials and Methods: Plain radiographs (anteroposterior and lateral views of lumbosacral spine and KUB radiographs) of 947 patients (646 with lumbosacral spine and 301 with KUB radiographs) done from August 2015 to July 2016 and meeting inclusion criteria were retrospectively analyzed for the presence of lumbosacral transitional vertebra.Results: The overall prevalence of lumbosacral transitional vertebra was 14.7% with prevalence of 16.3% in patients with lumbosacral radiographs and 11.3% in patients with KUB radiographs and was statistically significant. Prevalence of sacralization was higher than lumbarization (11.9% Vs 2.7%). Lumbosacral transitional vertebra was more common in females than in males with Castellvi type I being most common and type IV least common.Conclusion: The overall prevalence of lumbosacral transitional vertebra in the studied Nepalese population was 14.7% with significantly higher prevalence in patients with lumbosacral radiographs than with KUB radiographs.Asian Journal of Medical Sciences Vol.9(4) 2018 46-50
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KURTULUŞ, Burhan, Osman Yağız ATLI, and Evrim DUMAN. "The prevalence of anomalies in the lumbar spine in the Turkish male population." Anatolian Current Medical Journal 5, no. 4 (2023): 470–72. http://dx.doi.org/10.38053/acmj.1353209.
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Aims: It was aimed to determine the prevalence of lumbosacral anomalies in young male population.
 Methods: 56.798 male patients, between 18-49 years old, were included in this study during their medical screening in Dışkapı Yıldırım Beyazıt Training and Research Hospital from July 2016-July 2020. The presence of spina bifida occulta (SBO) and transitional vertebrae (TV) anomalies were recorded in the candidates. SBO patients were evaluated according to their S1 and L5 origins, and TV patients were evaluated separately according to sacralization and lumbarization. We identified transitional vertebrae by counting down from the last thoracic vertebra on the AP X-rays, then if necessary looking at the lateral view for confirmation. If hypoplastic ribs were identified, the vertebra immediately beneath would be designated as L1. Castellvi types I, II, III, and IV were included as transitional states.
 Results: 56798 patients were evaluated retrospectively. The mean age of the patients was 23.28 (18-49 years). Radiological anomalies were detected in 2577 (4.5%) of 56798 cases. No radiological anomaly was observed in other cases. Spina bifida occulta was detected in 1478 (2,6%) patients. Lumbosacral transitional vertebrae were detected in 1099 cases (1.9%). 745 (1.3%) of these anomalies are sacralization and 354 (0.6%) of them are lumbalization.
 Conclusion: In the light of this information, we think that knowing the frequency of lumbosacral anomalies, especially LSVT, in our society should be considered in the evaluation before spinal surgery operations.
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Skryabin, E. G., A. Yu Krivtsov, O. A. Kicherova, P. B. Zotov, and D. R. Dzhuraev. "Modern classifications of lumbosacral transitional vertebrae in patients with lumbodynia." Russian Journal of Pain 23, no. 2 (2025): 76. https://doi.org/10.17116/pain20252302176.
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Objective. To analyze modern classifications of lumbosacral transitional vertebrae. Material and methods. We reviewed the PubMed database (USA) using the keywords “lumbosacral transitional vertebra” and found 519 relevant manuscripts. Results. In modern literature, there is information about 7 classifications of lumbosacral transitional vertebrae in patients with lumbar pain. The most popular classification was proposed by Castellvi A.E. et al. This grading system was used by the authors of 92.9% of articles. Classification by C.M. O’Driscoll et al. was used by 4.4% of authors, classification by N.K. Mahato — 1.2% A.L. Jenkins et al. — 0.6%. Classifications by P.G. Tini et al., J. Knopf et al. and V.A. Byvaltsev et al. were used only by their developers (0.3%). Finally, we enrolled 23 articles with data on classifications of lumbosacral transitional vertebrae in patients with lumbodynia. Conclusion. Classification by A.E. Castellvi et al. is currently the most popular among specialists studying this disease. The most promising are classification by A.L. Jenkins et al. and V.A. Byvaltsev et al. published in 2023.
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Freedman, B. "Conus Medullaris Level in Vertebral Columns With Lumbosacral Transitional Vertebra." Yearbook of Orthopedics 2016 (2016): 115–16. https://doi.org/10.1016/j.yort.2016.05.095.
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Tanaka, Naoko, Hiroshi Kinoshita, Mostofa Jamal, Kunihiko Tsutsui, Hiroyuki Motomura, and Kiyoshi Ameno. "A forensic case of sacralization of the sixth lumbar vertebra in skeletal remains." Bangladesh Journal of Medical Science 12, no. 2 (2013): 224–26. http://dx.doi.org/10.3329/bjms.v12i2.14977.
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Lumbosacral transitional vertebrae (LSTVs) are a common congenital anomaly of the spine. In the present case, we observed LSTVs in the excessive (sixth lumbar) vertebra. In forensic practice, this anomaly may be useful for personal identification of skeletal remains. Bangladesh Journal of Medical Science Vol. 12 No. 02 April13 Page 224-226 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14977
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Steffen, Frank, Markus Berger, and Joe P. Morgan. "Asymmetrical, Transitional, Lumbosacral Vertebral Segments in Six Dogs: A Characteristic Spinal Syndrome." Journal of the American Animal Hospital Association 40, no. 4 (2004): 338–44. http://dx.doi.org/10.5326/0400338.
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Clinical findings in six dogs with asymmetrical, transitional, lumbosacral vertebral segments are reported. All dogs exhibited low back pain and varying degrees of asymmetrical cauda equina dysfunction. Results of myelography, epidurography, and magnetic resonance imaging (MRI) indicated a unilateral disk protrusion in all dogs. In the dogs with MRIs, focal degenerative alterations in the vertebral end plates and adjacent body of the vertebra were detected. All dogs were treated with a dorsal laminectomy or hemilaminectomy. Results following surgery were good or excellent in all six dogs.
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Gul, Nadia, Khalid Mehmood, and Muhammad Ikram. "RETROSPECTIVE DATA REVIEW TO FIND THE ASSOCIATION OF LUMBOSACRAL TRANSITIONAL VERTEBRA AND DEGENERATIVE DISC DISEASE IN YOUNG PATIENTS." Pakistan Armed Forces Medical Journal 70, no. 6 (2020): 1734–39. http://dx.doi.org/10.51253/pafmj.v70i6.3997.
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Objective: To find out the frequency of lumbar disc degeneration among the patients having lumbosacraltransitional vertebra between 20-40 years.
 Study Design: Retrospective cross sectional study.
 Place and Duration of Study: Radiology department POF Wah Cantt, from Jan 2018 to Dec 2019.
 Methodology: Six Hundred patients between 20-40 years having lumbosacral transitional vertebra and historyof low back pain >1 year were studied. X ray and MRI lumbar spine of these patients was studied retrospectivelyon PACS. Two hundred patients having history of traumatic or other non-traumatic etiologies, in addition toLumbosacral transitional vertebra were excluded. Four hundred patients with only lumbosacral transitionalvertebra were included. Data analysis was done by SPSS-22. Castellvi types of transitional vertebra was calculated among patients with degenerative lumbar disc.
 Results: One hundred and four (26.6%) were having degenerative disc disease while 296 (74.4%) patients werenot having degenerative disc disease. Patients having degenerative disc disease were between 24-40 years withthe mean age 29.96 ± 0.417 years. Among the patients having degenerative disc disease were 59 women and45 males but no statistical significance association was found between gender and degenerative disc disease with p-value = 0.55. Castellvi type III had significant association with degenerative disc disease, p-value = 0.006.
 Conclusion: Age related disc degeneration is commonly seen in middle age people but in younger age group in2nd and 3rd decade it is observed frequently in those patients having lumbosacral transitional vertebra especially in the setting of no other associated traumatic or non-traumatic etiology, which leads to early degenerative disc disease.
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Saluja, Sandeep, Sneh Agarwal, Anita Tuli, Shashi Raheja, and Sarika Rachel Tigga. "Morphological Variations of Sacrum in Adult Indian Population." International Journal of Anatomy and Research 10, no. 1 (2022): 8230–37. http://dx.doi.org/10.16965/ijar.2021.193.
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Introduction: The sacrum is considered as a highly variable bone. Several morphological variations have been documented which exhibit differences in the frequency of occurrence and morphological characteristics in various study populations. Variant anatomy of the sacrum may be associated with backache, enuresis, neurological anomalies of the lower limb and functional disorders of lower urinary tract. Purpose: The purpose of this study was to identify and describe morphological variations of sacrum in Indian population and enable comparison with different populations. Materials and Methods: The study was conducted on 108 dry adult human sacra and morphological characteristics and variations were noted. Results: Sacral skewness was observed in 7.4% sacra with right sided skewness being predominant. The presence of accessory auricular surface (AAS) was noted in 13% sacra which was at the level of S3 vertebra in most sacra. Spina bifida (SB) was observed in 11.1% sacra and it was most commonly located at S1 vertebral level. Furthermore, the lumbo-sacral transitional vertebra (TV) was documented in 10.2% sacra. Conclusions: Sacrum displays numerous variations in Indian population such as skewness, AAS, SB and TV. Thorough knowledge of morphological characteristics and variations of sacrum is vital and should be contemplated during diagnosis and treatment of sacrum-related diseases. KEY WORDS: Accessory auricular surface, Spina bifida, Transitional vertebra, Sacral skewness, Variations.
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Sonoda, Hideki, Tetsuya Hirano, Haruaki Takeuchi, et al. "A Genetic Study on Lumbosacral Transitional Vertebra." Orthopedics & Traumatology 40, no. 1 (1991): 243–44. http://dx.doi.org/10.5035/nishiseisai.40.243.
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Sharma, Vandana A., Deepak Sharma, Abhijeet Yadav, and Ritubala Soni. "Block lumbosacral transitional vertebra – A case report." Journal of the Anatomical Society of India 65 (September 2016): S103—S104. http://dx.doi.org/10.1016/j.jasi.2016.08.329.
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Kim, Jin-Tae, Jae-Hyon Bahk, and Joohon Sung. "Influence of Age and Sex on the Position of the Conus Medullaris and Tuffier's Line in Adults." Anesthesiology 99, no. 6 (2003): 1359–63. http://dx.doi.org/10.1097/00000542-200312000-00018.
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Background The purpose of this study was to analyze the position of the conus medullaris and Tuffier's line in the same patient population, to correlate this position with age and sex, and to determine an objective guide for the selection of a safe intervertebral space during spinal block. Methods Magnetic resonance imaging studies of the lumbar spine were reviewed in 690 consecutive patients. The study population consisted of patients older than 20 yr who had been referred for imaging to assess possible causes of low back pain. The position of the conus medullaris was defined as the most distal point of the cord that could be visualized on the sagittal sequence. A line perpendicular to the long axis of the cord was extended to the adjacent vertebra. In the lumbar plain films, the Tuffier's line was defined by drawing a horizontal line across the highest points of the iliac crests. Each vertebral body and intervertebral space was divided into four segments: upper, middle, and lower thirds of a vertebral body, and the intervertebral space. Each segment of a vertebral body or intervertebral space that the lines crossed was identified and recorded. The positions, stratified by decade of age, were compared using analysis of variance. The Tukey test was used for post hoc comparisons. Comparisons between sex were performed with the unpaired t test. Results The conus medullaris and Tuffier's line (median [range]) were positioned at L1-lower (T12-upper-L3-upper) and L4L5 (L3L4-L5S1), respectively. The distance between the conus medullaris and Tuffier's line (mean +/- SD [range]) was 12.6 +/- 1.9 [7-18] segments, which corresponded to the height of approximately three vertebral bodies and intervertebral spaces. In no case did Tuffier's line overlap with the conus medullaris. The distance in segments between the conus medullaris and Tuffier's line was shorter with increased age (P &lt; 0.001). The position of the conus medullaris and Tuffier's line was lower in female patients than in male patients (P &lt; 0.001) and higher in patients with sacralization than in those with lumbarization or without transitional vertebra (P &lt; 0.001). The in-between distances were not significantly different regardless of sex or presence of transitional vertebra. Conclusions During spinal block, there seems to be a safety margin of 2-4 vertebral bodies and intervertebral spaces between the conus medullaris and Tuffier's line, which is consistent regardless of sex or presence of transitional vertebra. However, because the conus medullaris and Tuffier's line become closer with age and the clinical use of Tuffier's line requires palpation through subcutaneous fat, caution must be exercised regarding selection of the intervertebral space, especially in the aged and obese population.
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Schultz, VA, and AG Watson. "Lumbosacral transitional vertebra and thoracic limb malformations in a Chihuahua puppy." Journal of the American Animal Hospital Association 31, no. 2 (1995): 101–6. http://dx.doi.org/10.5326/15473317-31-2-101.
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A three-month-old, male Chihuahua puppy with congenital absence of the distal 40% of the right thoracic limb was examined. The limb ended as a short, rounded, skin-covered stump. Radiography revealed a 40% shortened humerus tapered to a blunt end without its distal extremity. Dissection of the left thoracic limb identified luxation of the elbow joint and absence of the fourth digital pad. Alizarin-red staining and clearing demonstrated syndactylous fourth and fifth digits in the left thoracic limb and an anomalous eighth lumbar vertebra. This additional vertebra was unilaterally sacralized and constituted a lumbosacral transitional vertebra.
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Uçar, Demet, Bekir Yavuz Uçar, Yahya Coşar, et al. "Retrospective Cohort Study of the Prevalence of Lumbosacral Transitional Vertebra in a Wide and Well-Represented Population." Arthritis 2013 (June 24, 2013): 1–5. http://dx.doi.org/10.1155/2013/461425.
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Purpose. The aim of this study is to determine the prevalence of lumbosacral transitional vertebra (LSTV) in a well-represented general population. Methods. For a retrospective cohort study, abdominal radiographs of adult subjects were queried with clear visibility of the vertebral body articulation of the last rib, all lumbar transverse processes, and complete sacral wings. Exclusion criteria included any radiologic evidence of previous lumbosacral surgery that would block our view. A total of 6200 abdominal films were reviewed, and 3607 were identified as being suitable for the measurement of the desired parameters. Results. A total of 3607 subjects were identified as eligible for the study, and 683 (18.9%) were classified as positive for a lumbosacral transitional vertebra. The prevalence of sacralization and lumbarization was found as 17.2% and 1.7%, respectively. The average age at the time of the study was 39.5±15.2 years (18–86 years). Conclusions. As a result of different opinions, LSTV retains its controversial status. Our prevalence study of the general population will provide assistance for resolution of the controversy. Prevalence studies of the general population with a wide participation will shed light on comparative studies.
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Shah, Ali Raza, Sana Farid, Fahim Khan, and Sohail Hafeez. "Incidence of Lumbosacral Transitional Vertebrae in Patients with Low Back Pain." Pakistan Journal of Medical and Health Sciences 16, no. 9 (2022): 374–76. http://dx.doi.org/10.53350/pjmhs22169374.
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Background: The lumbar spine's lumbrosacral transitional vertebrae (LSTV), a structural defect, have been variously linked to low back pain (LBP). Their presence can also lead to an incorrect pre-operative level identification. Objective: To examine the relationship between lumbosacral transitional vertebrae detected on plain radiographs and low back pain in patients. Study Setting: Department of orthopedics, Shifa international hospital, Islamabad Methods: The study design was prospective and descriptive. The study was conducted between July 2021 to December 2021. The radiographs of 100 patients with low back pain who met the inclusion/exclusion criteria were evaluated. The frequency of patients with low back pain and lumbosacral transitional vertebra (LSTV) was calculated using SPSS version 26. For the quantitative data presentation mean and standard deviation was utilized and for qualitative data frequencies were used. P value less than 0.05 was considered significant. Results: In a sample of 100 patients, 40 were men and 60 were women. 45 patients were diagnosed with axial type of lower back pain. The prevalence of LSTV was 27%, with males constituting the majority. No significant difference in the LSTV and Normal spine age distribution intervals was observed except, in the age interval of 51-60 years with a P-Value of <0.001. Conclusion: There is substantial evidence linking lumbosacral transitional vertebrae and low back pain.
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Adibatti, Mallikarjun, and K. Asha. "Lumbarisation of the First Sacral Vertebra a Rare Form of Lumbosacral Transitional Vertebra." International Journal of Morphology 33, no. 1 (2015): 48–50. http://dx.doi.org/10.4067/s0717-95022015000100007.
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M, Lalit, Piplani S, and Piplani N. "Exploring the Anatomical and Clinical Perspectives of the Vertebra Prominens (C7)." Journal of Human Anatomy 8, no. 1 (2024): 1–15. https://doi.org/10.23880/jhua-16000207.
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The vertebra prominens is unique for its palpable prominence at the dorsum of the neck that serves as a key landmark in both clinical examinations and surgical procedures. Anatomical and morphometric aspects of the vertebra prominens also play a very important role in degenerative, traumatic and neoplastic diseases of the cervical spine and also as a reference point in surgery. This e-book “Exploring the Anatomical and Clinical Perspectives of the Vertebra Prominens” provides an in-depth analysis of its morphological and morphometric components. Dry bone specimens were utilized to measure vertebra prominens’s key parameters, including body dimensions, pedicle, laminae, spinous process, and the diameters of the foramen transversarium and vertebral foramen. Morphological variations of vertebra prominens include differences in the shape, size and presence of the foramen transversarium, bifid or elongated spinous processes, and cervical ribs. Studies on its morphometry highlight variability in the body, foramen transversarium and pedicle dimensions, with implications for conditions such as thoracic outlet syndrome and cervical spine trauma. Ethnic variations have also been reported in these dimensions. Its transitional design reflects the evolutionary balance between stability and mobility in the cervical-thoracic junction. The knowledge of such variations is critical for planning surgical interventions, understanding neurovascular compression syndromes, and enhancing diagnostic precision in cervical spine imaging. These parameters of vertebra prominens(C7) with combined effects of axial computed tomography, provide valuable insights in correct estimation of spinal deformities and are of interest from anatomical, anthropological and medicolegal point of view.
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Illeez, O. G., F. E. Bahadir Ulger, and I. Aktas. "AB0970 THE RELATION BETWEEN CONGENITAL STRUCTURAL MALFORMATIONS, DISC-VERTEBRA DEGENERATION AND DISC HERNIATION IN THE PEDIATRIC AGE GROUP." Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 1780.2–1780. http://dx.doi.org/10.1136/annrheumdis-2020-eular.558.
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Background:Disc/vertebral degeneration and disc herniation are rare causes of low back pain in childhood. Their relationship with congenital anomalies were reviewed in few studies in literature (1-3).Objectives:To examine the relation between congenital structural malformations in the lumbar spine, early degeneration and lumbar disc herniation in pediatric age group patients with low back pain, and to determine the incidence of congenital structural malformations, disc/vertebral degeneration, and disc herniation.Methods:Four hundred patients with LBP persisting for at least six weeks were included in the study. Demographic characteristics, physical examination findings, and laboratory and imaging results were recorded for all patients. Severity of pain was determined using a visual analog scale (VAS). Lumbosacral X-rays were examined for the presence of lumbosacral transitional vertebrae (LSTV) and spina bifida occulta (SBO). The incidence of disc/vertebral degeneration and disc herniation was investigated at the L4-5 and L5-S1 level in lumbosacral magnetic resonans imaging of patients with and without congenital malformation (LSTV-SBO).Results:The study population consisted of 219 girls and 181 boys aged 10-17 years (mean age 14.9±1.9). Presentation symptoms were low back pain in 90.5% (n= 362), and low back-leg pain in 9.5% (n=38). The mean VAS score was 5.3±1.0. LSTV was determined in 67 (16.8%) patients and SBO in 62 (15.5%). Disc herniation was determined in 68 patients, at the L4-5 level in 26.5% (n=18), at the L5-S1 level in 48.5% (n=33), and at both levels in 25% (n=17). Vertebral degeneration was present at the L4-5 level in 14 (8.6%) patients and at the L5-S1 level in 39 (23.9%), while disc degeneration was present at the L4-5 level in 21 (12.8%) patients and at the L5-S1 level in 31 (19.0%). No significant difference was observed in the incidence of disc/vertebral degeneration and disc herniation in patients with congenital malformation. Disc herniation was significantly more common in patients with disc degeneration (p=0.003, p<0.001). Congenital malformations were not observed in approximately 80% of patients without disc herniation and disc/vertebral degeneration.Conclusion:The presence of congenital malformations does not appear to represent a risk factor for early degeneration and disc herniation in pediatric age group. Congenital malformations, early degeneration, and disc herniation may constitute an underlying pathology in pediatric patients with persistent low back pain.References:[1]Milicić G, et al. Causal connection of non-specific low back pain and disc degeneration in children with transitional vertebra and/or Spina bifida occulta: role of magnetic resonance--prospective study. Coll Antropol. 2012.[2]Dang L, et al. Lumbar Disk Herniation in Children and Adolescents: The Significance of Configurations of the Lumbar Spine. Neurosurgery. 2015.[3]Zhang B, et al. Lumbosacral Transitional Vertebra: Possible Role inthe Pathogenesis of Adolescent Lumbar Disc Herniation. World Neurosurg. 2017.Disclosure of Interests:None declared
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Skryabin, E. G., A. Yu Krivtsov, O. A. Kicherova, I. N. Klokov, P. B. Zotov, and M. A. Akselrov. "Lumbosacral transitional vertebrae in children and adolescents (literature review, illustrated with clinical observations)." Genij Ortopedii 30, no. 2 (2024): 282–91. http://dx.doi.org/10.18019/1028-4427-2024-30-2-282-291.
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Introduction An analysis of the medical literature devoted to various aspects of transitional lumbosacral vertebrae shows that there are very few publications covering the course of this disease in the pediatric and adolescent population.Aim To study the issues of epidemiology, diagnosis, treatment and prevention of transitional lumbosacral vertebrae in paediatric and adolescent patients based on the analysis of current medical literature and illustrate the material with our own clinical observations.Material and methods To analyze the literature on the topic, 75 papers published between 1984 and 2023 were selected. Among them, there were 7 (9.3 %) domestic literary sources, 68 (90.7 %) were foreign. In the process of searching for scientific articles, the resources of the electronic databases of current medical information PubMed and CyberLeninka were used.Results and discussion The incidence of transitional vertebrae in children and adolescents is 16.8 % of clinical observations, as reported. In the structure of the transitional vertebrae in children, type II of the disease predominates according to the classification Castellvi et al (1984), 43.2 % of cases. The main clinical symptom of the pathology is pain of lumbosacral location, the intensity of which on the visual analog scale in children corresponds to an average of 3.0 points. In adult patients with similar pathology, the average pain intensity measured with the same scale is 7.5 points. The most informative method for diagnosing the disease is computed tomography, which allows obtaining both 3D images and sections at the level of pseudarthrosis between the enlarged transverse process (or processes) of the suprasacral vertebra and the wing of the sacrum. To relieve pain in children with transitional vertebrae, both conservative and surgical methods are used. The most commonly used procedure is pseudarthrectomy. The study of long-term results one year after the intervention allowed us to record the absence of pain in children who underwent surgery. Prevention measures for transitional lumbosacral vertebrae have not been developed.Conclusion The analysis of the published literature shows that transitional vertebrae are a frequently diagnosed pathology in children and adolescents. Current methods of imaging are able to accurately detect not only the presence of the disease, but also to differentiate its type. The main clinical symptom of transitional vertebrae is pain in the lumbosacral spine which is difficult to relieve with conservative therapy. Pseudarthrectomy is the most frequent surgical method of treatment in children and adolescents that provides stable relief of vertebrogenic pain syndrome. Measures for specific prevention of the disease have not been developed.
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Prasad, Tadikonda Bhavani, Sameer Chaitanya Sahini, and Tadikonda Krishna Srivathsav. "CASE REPORT OF LUMBOSACRAL TRANSITIONAL VERTEBRA (BERTOLOTTI’S SYNDROME)." Journal of Evolution of Medical and Dental Sciences 8, no. 19 (2019): 1595–97. http://dx.doi.org/10.14260/jemds/2019/353.
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Illeez, Ozge Gulsum, Arzu Atıcı, Esra Bahadır Ulger, Duygu Geler Kulcu, Feyza Unlu Ozkan, and Ilknur Aktas. "The transitional vertebra and sacroiliac joint dysfunction association." European Spine Journal 27, no. 1 (2016): 187–93. http://dx.doi.org/10.1007/s00586-016-4879-4.
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Jagannathan, Devimeenal, Venkatraman Indiran, Fouzal Hithaya, M. Alamelu, and S. Padmanaban. "Role of Anatomical Landmarks in Identifying Normal and Transitional Vertebra in Lumbar Spine Magnetic Resonance Imaging." Asian Spine Journal 11, no. 3 (2017): 365–79. http://dx.doi.org/10.4184/asj.2017.11.3.365.
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<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>Identification of transitional vertebra is important in spine imaging, especially in presurgical planning. Pasted images of the whole spine obtained using high-field magnetic resonance imaging (MRI) are helpful in counting vertebrae and identifying transitional vertebrae. Counting vertebrae and identifying transitional vertebrae is challenging in isolated studies of lumbar spine and in studies conducted in low-field MRI. An incorrect evaluation may lead to wrong-level treatment. Here, we identify the location of different anatomical structures that can help in counting and identifying vertebrae.</p></sec><sec><title>Overview of Literature</title><p>Many studies have assessed the vertebral segments using various anatomical structures such as costal facets (CF), aortic bifurcation (AB), inferior vena cava confluence (IC), right renal artery (RRA), celiac trunk (CT), superior mesenteric artery root (SR), iliolumbar ligament (ILL) psoas muscle (PM) origin, and conus medullaris. However, none have yielded any consistent results.</p></sec><sec><title>Methods</title><p>We studied the locations of the anatomical structures CF, AB, IC, RRA, CT, SR, ILL, and PM in patients who underwent whole spine MRI at our department.</p></sec><sec><title>Results</title><p>In our study, 81.4% patients had normal spinal segmentation, 14.7% had sacralization, and 3.8% had lumbarization. Vascular landmarks had variable origin. There were caudal and cranial shifts with respect to lumbarization and sacralization. In 93.8% of cases in the normal group, ILL emerged from either L5 alone or the adjacent disc. In the sacralization group, ILL was commonly seen in L5. In the lumbarization group, ILL emerged from L5 and the adjacent disc (66.6%). CFs were identified at D12 in 96.9% and 91.7% of patients in the normal and lumbarization groups, respectively. The PM origin was observed from D12 or D12–L1 in most patients in the normal and sacralization groups.</p></sec><sec><title>Conclusions</title><p>CF, PM, and ILL were good identification markers for D12 and L5, but none were 100% accurate.</p></sec>
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Cheng, Linxiang, Chao Jiang, Jiawei Huang, Jiale Jin, Ming Guan, and Yue Wang. "Lumbosacral Transitional Vertebra Contributed to Lumbar Spine Degeneration: An MR Study of Clinical Patients." Journal of Clinical Medicine 11, no. 9 (2022): 2339. http://dx.doi.org/10.3390/jcm11092339.
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We aimed to comprehensively characterize degenerative findings associated with various types of lumbosacral transitional vertebra (LSTV) on magnetic resonance images. Three hundred and fifty patients with LSTV (52.3 ± 10.9 years), including 182 Castellvi type I, 107 type II, 43 type III, and 18 type IV, and 179 controls without LSTV (50.6 ± 13.1 years), were studied. Discs, endplates, and posterior vertebral structures were assessed and compared to those of controls for the most caudal three discs on MRIs. There were no differences in degenerative findings between patients with type I LSTV and controls. For types III and IV, the transitional discs had smaller sizes, lower Pfirrmann scores, and lower rates of disc bulging (2.3% and 5.6% vs. 39.1%), osteophytes (2.3% vs. 15.1%), disc herniation (2.3% and 5.6% vs. 31.8%), and Modic changes (2.3% and 5.6% vs. 16.8%) than controls. However, the cranial discs had more severe Pfirrmann scores, disc narrowing and spinal canal narrowing, and greater rates of disc herniation (41.9% and 50.0% vs. 25.7%), endplate defects (27.9% and 33.3% vs. 14.4%) and spondylolisthesis (18.6% vs. 7.3%) than controls. Type II LSTV was associated with degenerative findings in the cranial segments but to a lesser degree, as compared with type III/IV LSTV. Thus, Castellvi type III/IV LSTV predisposed the adjacent spinal components to degeneration and protected the transitional discs. Type II LSTV had significant effects in promoting transitional and adjacent disc degeneration. Type I LSTV was not related to spinal degeneration.
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Homer, Cole J., and Jonathan N. Sembrano. "Sagittal radiographic parameters in the presence of lumbosacral transitional vertebra (LSTV): relationships between measurements using the upper vs lower transitional vertebra." Spine Deformity 9, no. 4 (2021): 875–81. http://dx.doi.org/10.1007/s43390-021-00307-5.
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Brault, Jeffrey S., Jay Smith, and Bradford L. Currier. "Partial Lumbosacral Transitional Vertebra Resection for Contralateral Facetogenic Pain." Spine 26, no. 2 (2001): 226–29. http://dx.doi.org/10.1097/00007632-200101150-00020.
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Dean, C. E., C. K. Cebra, and A. A. Frank. "Persistent Cloaca and Caudal Spinal Agenesis in Calves: Three Cases." Veterinary Pathology 33, no. 6 (1996): 711–12. http://dx.doi.org/10.1177/030098589603300613.
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Three newborn calves were affected by caudal spinal dysgenesis or agenesis (coccygeal vertebra) and persistent cloaca. The cloacas were lined by a mixture of transitional and colonic epithelium. The vertebral column of one calf was internalized into the cloaca. The association of persistent cloaca and caudal spinal anomalies is thought to be related to cell loss in the caudal cell mass, which affects caudal spinal column formation and cleavage of the cloaca by the urorectal septum. This association is well documented in humans and has been reported in Manx cats. By extrapolation, it appears likely to exist also in neonatal calves. Identification of cloacal lesions in neonatal animals should be cause for careful examination of the vertebral column because many of the associated spinal lesions are occult.
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Albano, Domenico, Carmelo Messina, Angelo Gambino, et al. "Segmented lordotic angles to assess lumbosacral transitional vertebra on EOS." European Spine Journal 29, no. 10 (2020): 2470–76. http://dx.doi.org/10.1007/s00586-020-06565-7.
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Abstract Purpose To test the vertical posterior vertebral angles (VPVA) of the most caudal lumbar segments measured on EOS to identify and classify the lumbosacral transitional vertebra (LSTV). Methods We reviewed the EOS examinations of 906 patients to measure the VPVA at the most caudal lumbar segment (cVPVA) and at the immediately proximal segment (pVPVA), with dVPVA being the result of their difference. Mann–Whitney, Chi-square, and ROC curve statistics were used. Results 172/906 patients (19%) had LSTV (112 females, mean age: 43 ± 21 years), and 89/172 had type I LSTV (52%), 42/172 type II (24%), 33/172 type III (19%), and 8/172 type IV (5%). The cVPVA and dVPVA in non-articulated patients were significantly higher than those of patients with LSTV, patients with only accessory articulations, and patients with only bony fusion (all p < .001). The cVPVA and dVPVA in L5 sacralization were significantly higher than in S1 lumbarization (p < .001). The following optimal cutoff was found: cVPVA of 28.2° (AUC = 0.797) and dVPVA of 11.1° (AUC = 0.782) to identify LSTV; cVPVA of 28.2° (AUC = 0.665) and dVPVA of 8° (AUC = 0.718) to identify type II LSTV; cVPVA of 25.5° (AUC = 0.797) and dVPVA of − 7.5° (AUC = 0.831) to identify type III–IV LSTV; cVPVA of 20.4° (AUC = 0.693) and dVPVA of − 1.8° (AUC = 0.665) to differentiate type II from III–IV LSTV; cVPVA of 17.9° (AUC = 0.741) and dVPVA of − 4.5° (AUC = 0.774) to differentiate L5 sacralization from S1 lumbarization. Conclusion The cVPVA and dVPVA measured on EOS showed good diagnostic performance to identify LSTV, to correctly classify it, and to differentiate L5 sacralization from S1 lumbarization.
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Pallavi, Sahay, Sahay Bhawna, and K. Karn S. "A Morphometric Study to Assess the Lumbosacral Transitional Vertebrae and its Clinical Implications." International Journal of Current Pharmaceutical Review and Research 15, no. 12 (2023): 966–69. https://doi.org/10.5281/zenodo.13253939.
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AbstractAim: The aim of the present study was to assess the lumbosacral transitional vertebrae and its clinicalimplications.Methods: The present study included an examination of 100 adult sacra (75 male and 25 female) available in theDepartment of Anatomy, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India for thepresence of LSTV. Duration of study from June 2020 to May 2021Results: In the present study of 100 sacra, 75 (75%) were male and 25 (25%) were female. Only 20 showedLumbosacral Transitional Vertebrae and 80 were normal sacra. Out of 75 male sacra, 12 and out of 25 femalesacra, 8 were found to be Lumbosacral Transitional Vertebrae. Out of 20 LSTV, 15 sacrum showed completesacralization of 5th lumbar vertebrae, 2 sacrum showed simultaneous sacralization of 1st coccygeal vertebrae andincomplete lumbarization of 1st sacral vertebrae and 3 sacrum showed complete lumbarization of 1st sacralvertebrae. Out of total 20 Lumbosacral Transitional Vertebrae, 15 fall in Type III of Castellvi classification, all ofwhich were bilateral (IIIb). 5 fall in Type IV (mixed) category of Castellvi classification in which we foundunilateral pseudarthrosis with the adjacent sacral ala on the left side and complete fusion with the adjacent sacralala on the right side.Conclusion: LSTV is a benign anatomical variation of the lumbosacral spine that is most frequently encounteredby the spinal surgeon. The list of differential diagnosis should always include Bertolotti’s syndrome, wheninvestigating back pain in young patients. Knowledge of the biomechanical alterations within the spine caused byLSTVs will aid the radiologist in understanding and recognizing the imaging findings seen in patients with lowback pain and a transitional segment.
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Priyanka, Raj, and Kumar Barun. "A Morphometric Evaluation of Lumbosacral Transitional Vertebrae: An Observational Study." International Journal of Current Pharmaceutical Review and Research 16, no. 05 (2024): 308–11. https://doi.org/10.5281/zenodo.12786854.
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AbstractAim: The aim of the present study was to assess the lumbosacral transitional vertebrae and its clinicalimplications.Methods: The present study included an examination of 100 adult sacra (75 male and 25 female) available in theDepartment of Anatomy, Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India for the presenceof LSTV.Results: In the present study of 100 sacra, 75 (75%) were male and 25 (25%) were female. Only 20 showedLumbosacral Transitional Vertebrae and 80 were normal sacra. Out of 75 male sacra, 12 and out of 25 femalesacra, 8 were found to be Lumbosacral Transitional Vertebrae. Out of 20 LSTV, 15 sacrum showed completesacralisation of 5th lumbar vertebrae, 2 sacrum showed simultaneous sacralisation of 1st coccygeal vertebrae andincomplete lumbarisation of 1st sacral vertebrae and 3 sacrum showed complete lumbarisation of 1st sacralvertebrae. Out of total 20 Lumbosacral Transitional Vertebrae, 15 fall in Type III of Castellvi classification, all ofwhich were bilateral (IIIb). 5 fall in Type IV (mixed) cateogory of Castellvi classification in which we foundunilateral pseudarthrosis with the adjacent sacral ala on the left side and complete fusion with the adjacent sacralala on the right side.Conclusion: LSTV is a benign anatomical variation of the lumbosacral spine that is most frequently encounteredby the spinal surgeon. The list of differential diagnosis should always include Bertolotti’s syndrome, wheninvestigating back pain in young patients. Knowledge of the biomechanical alterations within the spine caused byLSTVs will aid the radiologist in understanding and recognizing the imaging findings seen in patients with lowback pain and a transitional segment.
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Mohammad, Nur, Md Atikur Rahman, Shamsul Arefin, et al. "Prevalence of Transitional Vertebra in Lumbar Disc Herniation in Bangabandhu Sheikh Mujib Medical University." Bangladesh Journal of Neurosurgery 12, no. 2 (2024): 76–85. http://dx.doi.org/10.3329/bjns.v12i2.71892.
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Background: Lumbosacral transitional vertebrae (LSTV) occur as a congenital anomaly in the segmentation of lumbosacral spine that occur during intrauterine life. LSTV includes lumbarization and sacralization of the lumbosacral region. A transitional vertebra(TV) may have varying formations, the common feature being an atypical lumbosacral articulation between transverse process of the most inferior lumbar vertebra and the sacrum. There has been a lot of discussion regarding the prevalence of LSTV in lumbar disc herniation(LDH). Most of the studies showed increased prevalence while other studies showed TV is an incidental finding and there is no increased prevalence in LDH. LDH is a quiet common ailment encountered in neurosurgical practice. Numerous causes have been attributed to it. LSTV might have great importance in patients who clinically seem to have LDH where it’s presence in plain X-ray might provide a supportive evidence for diagnosis and it can help to counsel the patient. We will be able to recommend a plain x-ray of lumbosacral spine first, having history and clinical findings suggestive of LDH and can save the cost of MRI investigation until decision for operation. Beside this LSTV is an important entity for spinal surgeons , radiologists and also for those who do interventional procedures in the spine. For this reason the prevalence of TV in LDH should be known. This study was not carried out in our country yet. So this study will enrich our demographic information and will also help the spinal surgeons to counsel the patients about their congenital spinal morphological variation and different facts related with this. Objectives: General objective of this study is to observe the prevalence of LSTV in patients with LDH. Specific objective of this study was to identify the diathroidal joint or fusion between transverse process of last lumbar vertebra and ala of sacrum, to count the vertebral number from C2 to S1 in whole spine screening film, to identify the transitional vertebra as sacralization or lumbarization or absence of TV, to predict the future possibility of development of LDH from plain X-ray of lumbosacral spine. Methods: This study was a cross sectional type of observational study and was conducted in Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU). The patients (N=45) who fulfilled the selection criteria was enrolled in this study. Patient’s data were recorded in a predetermined data sheet. Patients were informed in details about the study, its merits and demerits in easy and understandable language and then informed consent was taken. Also assurance was given that all the information and records would be kept confidential and the study result would help the neurosurgeons to counsel the patients with LSTV about future possibility of development of LDH from plain X-ray of lumbosacral spine. This study was not responsible for any additional harm to the patient and study had no potential risk to the patient and no experimental drugs were used in this study. Results: A total of 45 patients of LDH were studied to see the prevalence of lumbosacral TV in LDH. Based on history and clinical findings, 100% of patients presented with low back pain, 100% of patients presented with sciatica, and 62.2% presented with gait difficulty and 02.2% of patients presented with cauda equina syndrome. Mean age of patients having LDH herniation was 38.08 ± 10.15 years. LSTV was found in 31.11% of patients with LDH. In this study, LSTV was diagnosed by plain X ray of Lumbosacral spine (A/P view) and supplemented with MRI of L/S spine with screening of whole spine (in most cases). Diagnosis of transitional vertebra was done by researcher and was further confirmed by guide and faculty members of BSMMU. In relation to gender, prevalence of LSTV in male was 25.9% and in female was 38.9% which indicated higher prevalence of TV in female but this is not statistically significant (p value 0.356).Incidence of disc herniation in patients with TV was at the space above the transition in 85.7% of cases. The most likely explanation for this is that the motion segment cephalad to the LSTV has to bear additional stresses by virtue of it being juxtaposed to a relatively non-mobile segment Conclusion: This study reveals that the prevalence of LSTV in LDH is 31.11% which is near the upper limit of its prevalence(according to literature). Association of TV with LDH can not be obtained as a control group of patient without LDH was not considered. So further study should be carried out incorporating large number of patients with control group with long study period to generalize the findings to target population. Bang. J Neurosurgery 2023; 12(2): 76-85
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Ward, Carol V., Thierra K. Nalley, Fred Spoor, Paul Tafforeau, and Zeresenay Alemseged. "Thoracic vertebral count and thoracolumbar transition in Australopithecus afarensis." Proceedings of the National Academy of Sciences 114, no. 23 (2017): 6000–6004. http://dx.doi.org/10.1073/pnas.1702229114.
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The evolution of the human pattern of axial segmentation has been the focus of considerable discussion in paleoanthropology. Although several complete lumbar vertebral columns are known for early hominins, to date, no complete cervical or thoracic series has been recovered. Several partial skeletons have revealed that the thoracolumbar transition in early hominins differed from that of most extant apes and humans. Australopithecus africanus, Australopithecus sediba, and Homo erectus all had zygapophyseal facets that shift from thoracic-like to lumbar-like at the penultimate rib-bearing level, rather than the ultimate rib-bearing level, as in most humans and extant African apes. What has not been clear is whether Australopithecus had 12 thoracic vertebrae as in most humans, or 13 as in most African apes, and where the position of the thoracolumbar transitional element was. The discovery, preparation, and synchrotron scanning of the Australopithecus afarensis partial skeleton DIK-1-1, from Dikika, Ethiopia, provides the only known complete hominin cervical and thoracic vertebral column before 60,000 years ago. DIK-1-1 is the only known Australopithecus skeleton to preserve all seven cervical vertebrae and provides evidence for 12 thoracic vertebrae with a transition in facet morphology at the 11th thoracic level. The location of this transition, one segment cranial to the ultimate rib-bearing vertebra, also occurs in all other early hominins and is higher than in most humans or extant apes. At 3.3 million years ago, the DIK-1-1 skeleton is the earliest example of this distinctive and unusual pattern of axial segmentation.
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Luo, Yuxi. "Analysis of the Research Progress on the Impact of Lumbosacral Transitional Vertebra on the Lumbopelvic-Hip Complex." Current Research in Medical Sciences 3, no. 1 (2024): 78–84. http://dx.doi.org/10.56397/crms.2024.03.10.
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The lumbosacral transitional vertebra is a common congenital variation. The presence of LSTV can result in smaller benefits for the population after total hip arthroplasty. Although extensive research has been conducted on the association between LSTV and lumbopelvic-hip complex syndrome in populations undergoing total hip arthroplasty, with convincing evidence suggesting that the presence of LSTV can have a negative impact on the outcomes of total hip arthroplasty, there is currently a lack of exploration into the association between LSTV and hip joint anatomical development, as well as its correlation with lumbopelvic-hip complex syndrome. The lumbopelvic-hip complex (LPHC) is a key structure for maintaining body stability and transmitting forces. Lumbosacral transitional vertebra (LSTV) is one of the most common congenital variations at the lumbosacral junction, which has a certain influence on the line of force transmission to the pelvis and hip joints and plays a role in the occurrence and development of hip and lumbar back pain.
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Achta, A. F., O. Hamdaoui, M. Banao, et al. "Imaging of Bertolotti Syndrome." EAS Journal of Radiology and Imaging Technology 4, no. 6 (2022): 139–42. http://dx.doi.org/10.36349/easjrit.2022.v04i06.005.
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Bertolotti syndrome is a congenital spinal anomaly characterized by an abnormal enlargement of one or both transverse processes (mega-apophysis) of the most caudal lumbar vertebrae that articles or fuses with the sacrum and/or iliac bone resulting in a pseudo-articulation. This is often a factor that is not addressed in the evaluation and treatment of low back pain. The presence of a lumbosacral transitional vertebra is a common finding in the general population with a prevalence between 4 and 30%. However, Bertolotti syndrome should be considered a differential diagnosis of low back pain. The pathophysiology, epidemiology and treatment should be the subject of general knowledge of physicians who often treat this disease.
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Kim, Nam Hyun, and Kyung Soo Suk. "The Role of Transitional Vertebra in Spondylolysis and Spondyloytic Spondylolisthesis." Journal of the Korean Orthopaedic Association 30, no. 2 (1995): 286. http://dx.doi.org/10.4055/jkoa.1995.30.2.286.
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