Transitional Lumbosacral Anatomy

Lumbosacral transitional vertebrae have been classically identified by using lateral and ferguson radiographs fig 1. A transitional vertebra is an extra section of spinal bone that does not normally present in a typical anatomy.

Lumbosacral Transitional Vertebra Related Low Back Pain

For instance the transverse process of the last cervical vertebra may resemble a rib.

Transitional lumbosacral anatomy. In transitional lumbosacral vertebrae one of the vertebrae does not form as part of the lumbar or sacral area. This is likely l5 with partial fusion of the right transverse processthere is suggestion of a pseudojoint which can be a source of pain. The human spine is made up of 33 bones called vertebrae with the spinal cord running through the middle.

There is no fracture or spondylolisthesis. Lumbosacral transitional vertebrae lstv are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. Presence of six rib free lumbar type vertebrae which may have the following features squaring of highest sacral transitional vertebra.

Facet joints even rudimentary and intervertebral disc between s1 and s2. In 1984 castellvi et al described a radiographic classification system identifying 4 types of lstvs on the basis of morphologic characteristics fig 2. The vertebral body height and the remainer of the disk spaces are well maintain ed.

This review will focus on the clinical significance of lstv disruptions in normal spine biomechanics imaging techniques diagnosis and treatment. The pedicles are intact and the sacroiliac joints are unremarkable. There is marked narrowing of the l5 s1 disk space as well.

This alteration may contribute to incorrect identification of a vertebral segment leading to wrong level spine surgery and poor correlation with clinical symptoms. Transitional vertebrae are abnormally formed vertebral bones that display the characteristics of two different types of vertebrae. It occurs at the cervicothoracic thoracolumbar or lumbosacral junction.

A transitional vertebra at the lumbosacral junction can cause arthritis disk changes or spinal cord compression. Lumbosacral transitional vertebrae lstvs are a congenital vertebral anomaly of the l5 s1 junction in the spine. It is as if this one vertebra cannot make up its mind whether to be become a lumbar vertebra or a sacral vertebra.

These extra vertebrae usually occur at the lumbosacral juncture but can rarely also occur at the cervicothoracic frontier. The report says there is a transitional vertebra at the lumbosacral joint. Lumbosacral transitional vertebra lstv is a developmental spinal anomaly in which the lowest lumbar vertebra shows elongation of its transverse process and varying degrees of fusionfailure of segmentation from the sacrum.

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