Abstract
Lumbosacral transitional vertebra (LSTV) and spina bifida occulta (SBO) are widespread within the lumbosacral spine. Their connection to lumbar disc herniation (LDH) and/or lower back pain has been debated in the current literature; however, there is no consensus. The purpose of this study is to evaluate the relationship between the frequency of LSTV and SBO with that of LDH among young patients with chronic lower back pain. Cross-sectional. A total of 1094 patients with lower back pain, aged between 20 and 40 years, with lower back pain history persisting for longer than 12 weeks were studied. All the patients in the study were evaluated with standard pelvic radiographs and lumbar vertebra magnetic resonance imaging. The severity of pain was measured using the visual analog scale, and the effect of lower back pain on daily life activities was measured using the Oswestry disability index. The patients were separated into two groups: Group 1 consisted of patients without LDH, and Group 2 consisted of patients with LDH. Additionally, these two groups were separated into three subgroups: Non-LSTV-SBO, LSTV, and SBO. It was determined that LSTV frequency was significantly higher (p=0.004) in the lumbar disc herniation group 2. In addition, the existence of LSTV increased the risk of lower back pain (p<0.001, p<0.001) and disability (p<0.001, p<0.001) in young patients with and without LDH or not. However, the presence of SBO did not increase lower back pain (p=0.251, p=0.200) and disability (p=0.134, p=0.161) in both groups. A relationship was detected between the frequency of LDH and LSTV in young patients with chronic lower back pain between the ages of 20 and 40 years. Also, the presence of LSTV was found to increase the risk of lower back pain and disability.
Highlights
Lower back pain is a common problem
A relationship was detected between the frequency of lumbar disc herniation (LDH) and lumbosacral transitional vertebra (LSTV) in young patients with chronic lower back pain between the ages of 20 and 40 years
There were significant statistical differences between the spina bifida occulta (SBO) and LSTV subgroups, there were no significant statistical differences between the Non-LSVT-SBO and SBO groups. These results show that LSTV may increase lower back pain and limit daily activity regardless of whether lumbar discopathy is present
Summary
Lower back pain is a common problem. Congenital vertebral anomalies are often found, there is no consensus in the literature on the association between lower back pain and congenital vertebra malformation [2, 3]. Spina bifida occulta (SBO) and lumbosacral transitional vertebra (LSTV) are the most common congenital lumbosacral malformations [4, 5]; both generally involve the 5th lumbar vertebra. SBO is caused by a failed fusion between the posterior vertebral elements that does not affect the spinal cord or meninges. This malformation is generally observed at the 5th lumbar vertebra and/or 1 or 2 vertebrae above or below the 5th lumbar vertebra [6, 7]. The prevalence of SBO varies between 0.6% and 25% [4]
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