Is lumbosacral transitional vertebra associated with lumbar disc herniation in patients with low back pain?,European Spine Journal

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Is lumbosacral transitional vertebra associated with lumbar disc herniation in patients with low back pain?
European Spine Journal ( IF 2.6 ) Pub Date : 2022-09-05 , DOI: 10.1007/s00586-022-07372-y
Fatma Fidan ₁ , Mehtap Balaban ₂ , Şükrü Cem Hatipoğlu ₂ , Enejd Veizi ₃

Affiliation

Purpose

To evaluate lumbosacral transitional vertebrae (LSTV) frequency in patients with low back pain and lumbar disc herniation (LDH) and to analyze correlations between LSTV presence and intervertebral disc degeneration.

Methods

This retrospective study included patients with low back pain applying between January 2021 and August 2021. Inclusion criteria were age of 18–65, presence of a standing lumbosacral Xray and a lumbar MRI taken within 2 weeks of the indexed symptoms. Patients with a history of spondylolisthesis, spondylodiscitis, scoliosis and vertebral neoplasia were excluded. A total of 1821 patients met the inclusion criteria. Radiographs and MRIs were evaluated by 2 radiologists.

Results

Of all patients, 61.4% were female and the mean age was 43.2 ± 12.2. LDH was detected in 57.7% of patients while a LSTV was present in 43.3%. Sacralization and LSTV were significantly different between the patients with and without an LDH. Patients with LSTV had a higher incidence of a LDH affecting 3 or more intervertebral disc levels (p < 0.001). There was a significant difference in-between LSTV and non-LSTV groups regarding the M1 and M2 intervertebral disc degeneration levels.

Conclusion

A LDH is more common in the presence of a LSTV. Female sex is highly correlated with herniation. Three or more intervertebral disc levels are affected in the presence of an LSTV. Significantly higher degeneration incurs at the M1 and M2 intervertebral levels. Sacralization is a risk factors for a lumbar disc herniation.

中文翻译：

腰骶部移行椎与腰痛患者腰椎间盘突出症有关吗？

目的

评估腰痛和腰椎间盘突出症 (LDH) 患者的腰骶移行椎 (LSTV) 频率，并分析 LSTV 存在与椎间盘退变之间的相关性。

方法

这项回顾性研究包括在 2021 年 1 月至 2021 年 8 月期间申请的腰痛患者。纳入标准为 18-65 岁，在出现索引症状后 2 周内进行了站立式腰骶 X 线检查和腰椎 MRI 检查。有脊椎滑脱、椎间盘炎、脊柱侧凸和椎体肿瘤病史的患者被排除在外。共有 1821 名患者符合纳入标准。由 2 名放射科医师评估 X 光片和 MRI。

结果

在所有患者中，61.4% 为女性，平均年龄为 43.2 ± 12.2 岁。57.7% 的患者检测到 LDH，而 43.3% 的患者存在 LSTV。骶骨化和 LSTV 在有和没有 LDH 的患者之间有显着差异。LSTV 患者的 LDH 影响 3 个或更多椎间盘水平的发生率较高 ( p < 0.001)。在 M1 和 M2 椎间盘退变水平方面，LSTV 组和非 LSTV 组之间存在显着差异。