Abstract

Lumbosacral transitional vertebrae (LSTV), is a structural anomaly, of the lumbo-sacral spine in which an elongated transverse process of the last lumbar vertebra fuses with varying degree to the “first” sacral segment which has been variably associated with, low back pain (LBP) and its presence can also result in a level being wrongly identified pre-operatively. Objectives: To assess the prevalence and pattern of Lumbosacral Transitional vertebrae in patients presenting with Low Back pain. To assess the patient clinically and radiologically, to see if a co-relation exists between back pain in patients with LSTV. Methods: We conducted a Prospective observational study from the period of August 2019 to July 2021 in the Department of Orthopaedic Shyam Shah Medical College and Associated SGMH Hospital Rewa M.P. India, with a sample size of 500 patients. Study design: Prospective observational study Patients of both sexes in the age group of 20-45 years presenting low back pain of any duration were included in the study. Results: In our study, the incidence rate of LSTV was 28.8% against the reported 4.0%-35.9% with a mean of 12.3%. mean age of patients was calculated to be 35.5 years15, in our study of patients with LSTV, Male: Female ratio was 2.1:1. in our study, Sacralisation has been reported to be more common than lumbarisation. Sacralisation: Lumbarisation ratio in our study was 1.8:1. In our study, Type II and Type IV LSTV patients were most symptomatic in our study patients with Type I LSTV had lesser severity of low back pain as compared to patients without LSTV. Conclusion: The study shows that presence of Lumbosacral transitional vertebrae (Type II and Type IV) in patients with low back pain have a strong and positive correlation with the severity of pain and it also has an adverse effect on a patient’s daily activities. Due to the absence of consensus and controversial association of LSTV with low back pain, the incidence observed in our study assumes great significance. Our findings illustrate the importance of including Lumbosacral Transitional vertebrae in the list of differential diagnosis when investigating young and middle-aged patients with low back pain.

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