Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Herniated lumbar discs are a common cause of low back pain.
• Lumbosacral transitional vertebrae (LSTV) represent anatomical variations at the junction of the spine and pelvis.
• The association between LSTV and lumbar disc herniation requires further clarification.

Purpose of the Study:

• To investigate the relationship between LSTV and herniated lumbar disc (HLD).
• To classify LSTV based on morphologic and clinical characteristics related to HLD.
• To determine if LSTV influences the location and incidence of HLD.

Main Methods:

• Retrospective review of 200 consecutive patients with myelographically confirmed HLD.
• Identification of patients with LSTV based on abnormalities of the transverse process.
• Classification of LSTV into new types based on morphology and association with HLD.

Main Results:

• Sixty patients (30%) had LSTV.
• Type I LSTV showed no significant difference in HLD location.
• Types III and IV LSTV were not associated with HLD at or near the transition.
• Type II LSTV was significantly associated with HLD at the transitional level and the level immediately above.

Conclusions:

• LSTV, particularly Type II, is associated with an increased incidence of lumbar disc herniation.
• A new classification system for LSTV aids in understanding its clinical significance regarding HLD.
• Identifying LSTV may be important for diagnosing and managing patients with lumbar disc herniation.