[Sacralization of the 5th lumbar vertebra and backache: what's the possible relationship?]

Transitional vertebrae is a controversial problem in occupational health and in forensic medicine, in view of its prognostic value and especially because of the implications of law 626/94 which requires a worker assessment for manual handling tasks. The purpose of this review was to assess the relationship between transitional vertebrae and low back pain. Data sources comprised computer-aided search of published studies on Medline and Embase. There were seven studies evaluating the prevalence of the abnormality, the relationship with low back pain and the different aspects of spinal degeneration. Only two studies indicated a positive relationship with low back pain. Four studies reported absence of any prognostic value of this vertebral abnormality. One study examined a twenty year old population: even if it did not show a relationship with a higher incidence of disc degeneration with MRI, we did not include it in our review because of the young age of the samples. It is concluded that present knowledge does not reveal any correlation between transitional vertebrae and low back pain. Further studies are needed to support any conclusion about this important issue.