PREVALENCE OF LUMBOSACRAL TRANSITIONAL VERTEBRA IN PATIENTS PRESENTING WITH LOW BACKACHE AND IT'S ASSOCIATION WITH DEGENERATIVE SPINE CHANGES ON MRI: A STUDY IN RURAL TERTIARY CARE HOSPITAL OF SOUTH INDIA.

Abstract

Introduction- Lumbosacral transitional vertebra (LSTV) is a congenital spinal anomaly dened as either sacralization of lumbar segment or lumbarization of sacral segment of the spine. Identication of accurate level of pathology is of utmost importance in patients undergoing surgical intervention. Failure to do so, might result in wrong level surgery, leading to signicant morbidity. Aims and objectivesŸ To analyze the prevalence, age and sex distribution of LSTV in low back pain patients. Ÿ To analyze the various methods of identifying and numbering LSTV. Ÿ To explore the relationship between LSTV and degenerative spine changes. Materials and methods- This was a crossectional observational study done in 217 cases presented with low back pain and underwent MRI LS spine using PHILIPS Ingenia 1.5 Tesla machine in department of radio-diagnosis at MAHARAJAHS INSTITUTE OF MEDICAL SCIENCES, NELLIMARLA. LSTV prevalence was 18.8% in this study. Most of the patients Conclusion- with LSTV belonged to 4th and 5th decades. No signicant sex predilection was seen. Castellvi types II & IV are the most frequent types. An association between the transitional vertebra and herniation of the disc above was found in patients with low back pain i.e., Disc herniation was always noted above the transitional vertebra and not below that level (L4/5 disc prolapse in sacralization and L5/S1 disc prolapse in lumbarization), Sacralization was common than lumbarization in LSTV, approximately in the ratio of 2.3:1. The reliability of MRI ( sagittal MRI to count from C2, axial MRI to look for iliolumbar ligaments) to identify and correctly numbering LSTV was 100 %. Severity of degenerative spine changes was slightly higher among LSTV group than 'No LSTV' group