A Whole-Spine Magnetic Resonance Imaging–Based Cross-Sectional Study of the Clinicoradiological Association of Lumbosacral Transitional Vertebra with Degenerative Disc Disease, End Plate Degeneration, Low Back Pain, and Facet Tropism

Abstract

BackgroundThe purpose of the study is to understand the LSTV-associated degenerative pathologies and their correlation to low back pain(LBP) and radicular pain(RP). MethodsWhole spine MRIs were evaluated for disc degeneration using the Pfirrmann’s grading, for endplate changes using total end plate score (TEPS), and facet tropism in patients with LBP and RP. Their association to LSTV was analyzed. ResultsGroup 1LSTV was seen in 15% of patients with 83% of these patients having sacralization. Disc degeneration was seen in 58%, 51% and 63% of patients at levels C, B and A respectively, with sacralisation patients having significant degeneration at all 3 levels. Similarly the TEPS score and facet tropism was significantly higher in sacralisation patients. Facet tropism was observed in 31%, 40% and 35% of non-LSTV, sacralization and lumbarization patients, respectively.Group 2LSTV was seen in 17% patients with sacralization accounting for 82%. Disc degeneration was seen in 44%, 36%, and 54% patients at levels C, B and A respectively. No significant difference was observed in the mean TEPS scores between groups, however, Facet tropism was identified in 89% and 81% of sacralization and lumbarization patients, compared to in only 19% in non-LSTV patients. ConclusionOur study shows that low back pain patients have a higher incidence of sacralisation with corresponding disc degeneration, facet tropism and EPCs. Lumbarization had an association with only facet tropism in the radicular pain group. These findings may aid the clinician in prognostication and patient counselling.