title: Lumbosacral transitional vertebrae: association with low back pain.
abstract: OBJECTIVE
  To assess the prevalence and degree of lumbosacral transitional vertebrae (LSTV) in the Osteoarthritis Initiative (OAI) cohort, to assess whether LSTV correlates with low back pain (LBP) and buttock pain, and to assess the reproducibility of grading LSTV.
  
  
  METHODS
  Institutional review board approval was obtained, and informed consent documentation was approved for the study protocol. Standard standing pelvic radiographs that included the transverse processes of L5 were graded according to Castellvi classification of LSTV in 4636 participants (1992 men and 2804 women; aged 45-80 years) from the OAI cohort. These data were correlated with prevalence and severity of LBP and buttock pain.
  
  
  RESULTS
  Prevalence of LSTV was 18.1% (841 of 4636), with a higher rate in men than in women (28.1% vs 11.1%, respectively; P<.001). Of the 841 individuals with LSTV, 41.72% were type I (dysplastic enlarged transverse process), 41.4% were type II (pseudoarticulation), 11.5% were type III (fusion), and 5.2% were type IV (one transverse process fused and one with pseudoarticulation). Of the participants without LSTV, 53.9% reported LBP, while the prevalence of LBP for types I, II, III, and IV was 46%, 73%, 40%, and 66%, respectively (P<.05, χ2 test). Types II and IV had higher prevalence and severity of LBP and buttock pain (P<.001).
  
  
  CONCLUSIONS
  LSTV types II and IV positively correlate with prevalence and severity of LBP and buttock pain.
authors.affiliation: Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA. Lorenzo.Nardo@ucsf.edu
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Nardo
authors.forename: Hamza
authors.initials: H
authors.lastname: Alizai
authors.forename: Warapat
authors.initials: W
authors.lastname: Virayavanich
authors.forename: Felix
authors.initials: F
authors.lastname: Liu
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hernandez
authors.forename: John A
authors.initials: JA
authors.lastname: Lynch
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
mesh_terms: D000015:Abnormalities, Multiple; D000368:Aged; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008588:Meningocele; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D012445:Sacrococcygeal Region / Q000002:abnormalities / Q000000981:diagnostic imaging; D017678:Sex Distribution