Shabnum Aamir, Humaira Imtiaz, Zainab Rehman, Sadaf Ambreen, Fazal Ghani, Ayesha Naoureen


Background: Lumbosacral transitional vertebra is a common anatomical variant of the spine that possibly is related to low back pain. The objective is to determine the frequency of Lumbosacral Transitional Vertebrae on lumbosacral radiographs in patients with low back pain visiting Neurosurgery OPD of Khyber Teaching Hospital Peshawar Khyber Pakhtunkhwa (KP). Method:  This cross-sectional study was conducted on radiographs of lumbosacral spine in patients visiting for low back pain to the Neurosurgery OPD of Khyber Teaching Hospital Peshawar. A total of 300 anteroposterior (AP) and lateral lumbosacral plain radiographs were studied for the variation in lumbosacral spinal segment. The transition was classified according to the scheme used by Castellvi. Results: Among a total of 300 patients, normal anatomy of lumbosacral segments was observed in 215 patients (72%). About 85 cases (28%) showed Lumbosacral Transitional Vertebrae. The relationship of vertebral variation with age and gender was not observed. With regard to morphology, 29 (34.1%) patients had Castellvi type I, 26 cases (30.5%) were observed with Castellvi type II and 12 patients (14.1%) had type III while 18 cases (21.2%) had type IV transitional morphology. Conclusion: Lumbosacral Transitional Vertebrae are commonly found in patient with low back pain. Identification of Lumbosacral Transitional Vertebrae is clinically important to prevent an intervention at an incorrect vertebral level.

Keywords: Lumbosacral Transitional Vertebrae; Low back pain; Lumbosacral radiographs

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French HD, Somasundaram AJ, Schaefer NR, Laherty RW. Lumbosacral transitional vertebrae and its prevalence in the Australian population. Global Spine J 2014;4(04):229–32.

Apazidis A, Ricart PA, Diefenbach CM, Spivak JM. The prevalence of transitional vertebrae in the lumbar spine. Spine J 2011;11(9):858–62.

Shaikh A, Khan SA, Hussain M, Soomro S, Adel H, Adil SO, et al. Prevalence of Lumbosacral Transitional Vertebra in Individuals with Low Back Pain: Evaluation Using Plain Radiography and Magnetic Resonance Imaging. Asian Spine J 2017;11(6):892–7.

Akbar JJ, Weiss KL, Saafir MA, Weiss JL. Rapid MRI detection of vertebral numeric variation. AJR Am J Roentgenol 2010;195(2):465–6.

Kottlors M, Glocker FX. Dermatomyotomal supply in patients with variations in the number of lumbar vertebrae. J Neurosurg Spine 2010;12(3):314–9.

Nardo L, Alizai H, Virayavanich W, Liu F, Hernandez A, Lynch JA, et al. Lumbosacral transitional vertebrae: association with low back pain. Radiology 2012;265(2):497–503.

Luoma K, Vehmas T, Raininko R, Luukkonen R, Riihimäki H. Lumbosacral transitional vertebra: relation to disc degeneration and low back pain. Spine 2004;29(2):200–5.

Konin GP, Walz DM. Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. Am J Neuroradiol 2010;31(10):1778–86.

Hughes RJ, Saifuddin A. Numbering of lumbosacral transitional vertebrae on MRI: role of the iliolumbar ligaments. Am J Roentgenol 2006;187(1):W59–65.

Bressler EL. Numbering of lumbosacral transitional vertebrae on MRI. AJR Am J Roentgenol 2007;188(2):W210–1.

Castellvi AE, Goldstein LA, Chan DP. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine 1984;9(5):493–5.

Wigh RE. The thoracolumbar and lumbosacral transitional junctions. Spine (Phila Pa 1976) 1980;5(3):215–22.

Bron JL, van Royen BJ, Wuisman PI. The clinical significance of lumbosacral transitional anomalies. Acta Orthop Belg 2007;73(6):687–95.

Carrino JA, Campbell PD Jr, Lin DC, Morrison WB, Schweitzer ME, Flanders AE, et al. Effect of spinal segment variants on numbering vertebral levels at lumbar MR imaging. Radiology 2011;259(1):196–202.

Chalian M, Soldatos T, Carrino JA, Belzberg AJ, Khanna J, Chhabra A. Prediction of transitional lumbosacral anatomy on magnetic resonance imaging of the lumbar spine. World J Radiol 2012;4(3):97.

Sekharappa V, Amritanand R, Krishnan V, David KS. Lumbosacral transition vertebra: prevalence and its significance. Asian Spine J 2014;8(1):51–8.

Uçar BY, Uçar DE, Bulut M, Azboy I, Demirtaş A. Lumbosacral transitional vertebrae in low back pain population. J Spine 2013;2(125):2.

Magora A, Schwartz A. Relation between the low back pain syndrome and x-ray findings. Transitional vertebra (mainly sacralization). Scand J Rehabil Med 1978;10(3):135–45.


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