Transitional Lumbosacral Anatomy
This is likely l5 with partial fusion of the right transverse processthere is suggestion of a pseudojoint which can be a source of pain. In 1984 castellvi et al described a radiographic classification system identifying 4 types of lstvs on the basis of morphologic characteristics fig 2.
There is marked narrowing of the l5 s1 disk space as well.
Transitional lumbosacral anatomy. A transitional vertebra at the lumbosacral junction can cause arthritis disk changes or spinal cord compression. The human spine is made up of 33 bones called vertebrae with the spinal cord running through the middle. Lumbosacral transitional vertebra lstv is a developmental spinal anomaly in which the lowest lumbar vertebra shows elongation of its transverse process and varying degrees of fusionfailure of segmentation from the sacrum.
The pedicles are intact and the sacroiliac joints are unremarkable. A transitional vertebra is an extra section of spinal bone that does not normally present in a typical anatomy. Facet joints even rudimentary and intervertebral disc between s1 and s2.
There is no fracture or spondylolisthesis. This review will focus on the clinical significance of lstv disruptions in normal spine biomechanics imaging techniques diagnosis and treatment. Presence of six rib free lumbar type vertebrae which may have the following features squaring of highest sacral transitional vertebra.
Lumbosacral transitional vertebrae have been classically identified by using lateral and ferguson radiographs fig 1. For instance the transverse process of the last cervical vertebra may resemble a rib. This alteration may contribute to incorrect identification of a vertebral segment leading to wrong level spine surgery and poor correlation with clinical symptoms.
The report says there is a transitional vertebra at the lumbosacral joint. Lumbosacral transitional vertebrae lstvs are a congenital vertebral anomaly of the l5 s1 junction in the spine. It occurs at the cervicothoracic thoracolumbar or lumbosacral junction.
The vertebral body height and the remainer of the disk spaces are well maintain ed. Transitional vertebrae are abnormally formed vertebral bones that display the characteristics of two different types of vertebrae. It is as if this one vertebra cannot make up its mind whether to be become a lumbar vertebra or a sacral vertebra.
In transitional lumbosacral vertebrae one of the vertebrae does not form as part of the lumbar or sacral area. Lumbosacral transitional vertebrae lstv are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. These extra vertebrae usually occur at the lumbosacral juncture but can rarely also occur at the cervicothoracic frontier.
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