Lumbosacral transitional vertebra in the young men population with low back pain: anatomical considerations and degenerations (transitional vertebra types in the young men population with low back pain)

Introduction To evaluate the prevalence of subtypes of congenital lumbosacral transition vertebra (LSTV) in young male populations with low back pain (LBP) and their relationship to lumbar disc and facet degeneration. Materials and methods 1875 patients (male, aged; 18–40 years) with LBP were investigated retrospectively. Standard lumbar MRI protocol of sagittal, and axial T1 weighted images (WI) and T2 WI and coronal short tau inversion recovery (STIR) T2 WI were obtained. Castellvi classification of LSTV were used for subtyping. The level and above the level of LSTV were evaluated for the lumbar disc space and facet degeneration based on grading methods which compares subtype groups with each other. Results Prevalence of LSTV was 32% (600 of 1875). The most frequent LSTV types were type I (dysplastic enlarged transverse process; 66.5%) and type II (pseudoarticulation; 21.8%). Eight percent of the patients were type III (fusion) and 3.6% patients type IV (one transverse process fused and one with pseudoarticulation). The most commonly detected LSTV types were type I + II (88%) and all bilateral LSTV types were seen much more than unilateral types (bilateral versus unilateral 63.2%, 33.2%). The LSTV type I highly correlated with the disc degeneration and facet arthrosis. But the groups with higher grade of disc degeneration were type IV and III. Conclusion In young male patients with LBP, LSTV was found to be high in frequency and mostly occurred to be subtype I. LSTV type I and associated disk and facet degeneration were found to be remarkable in this group. Coronal T2 STIR images are useful in showing lumbosacral region anomalies and variants, and should be included in the routine lumbar MRI protocol.