title: Lumbosacral transition vertebra: prevalence and its significance.
abstract: METHODS
  Retrospective analysis of radiological images.
  
  
  OBJECTIVE
  To determine the prevalence of lumbosacral transition vertebra (LSTV) and to study its significance with respect to clinically significant spinal symptoms, disc degeneration and herniation.
  
  
  BACKGROUND
  LSTV is the most common congenital anomaly of the lumbosacral spine. The prevalence has been debated to vary between 7% and 30%, and its relationship to back pain, disc degeneration and herniation has also not been established.
  
  
  METHODS
  The study involved examining the radiological images of 3 groups of patients. Group A consisted of kidney urinary bladder (KUB) X-rays of patients attending urology outpatient clinic. Group B consisted of X-rays with or without magnetic resonance images (MRIs) of patients at-tending a spine outpatient clinic, and group C consisted of X-rays and MRI of patients who had undergone surgery for lumbar disc herniation. One thousand patients meeting the inclusion criteria were selected to be in each group. LSTV was classified by Castellvi's classification and disc degeneration was assessed by Pfirrmann's grading on MRI scans.
  
  
  RESULTS
  The prevalence of LSTV among urology outpatients, spine outpatients and discectomy patients was 8.1%, 14%, and 16.9% respectively. LSTV patients showed a higher Pfirrmann's grade of degeneration of the last mobile disc. Results were found to be significant statistically.
  
  
  CONCLUSIONS
  The prevalence of LSTV in spinal outpatients and discectomy patients was significantly higher as compared to those attending the urology outpatient clinic. There was a definite causal relationship between the transitional vertebra and the degeneration of the disc immediately cephalad to it.
authors.affiliation: Spinal Disorder Sugery Unit, Department of Orthopaedics, Christian Medical College, Vellore, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Sekharappa
authors.affiliation: Spinal Disorder Sugery Unit, Department of Orthopaedics, Christian Medical College, Vellore, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Amritanand
authors.affiliation: Spinal Disorder Sugery Unit, Department of Orthopaedics, Christian Medical College, Vellore, India.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Krishnan
authors.affiliation: Spinal Disorder Sugery Unit, Department of Orthopaedics, Christian Medical College, Vellore, India.
authors.forename: Kenny Samuel
authors.initials: KS
authors.lastname: David
keywords: Castellvi's classification; Discectomy patients; Lumbosacral transitional vertebra; Pfirrmann's grading; Spine outpatients; Urology outpatients