A Review of Symptomatic Lumbosacral Transitional Vertebrae: XXXX .

@entity1 @entity1643 @entity3466 @entity5040 @entity158 @entity244
BACKGROUND: Lumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. This review will focus on the clinical significance of LSTV, disruptions in normal spine biomechanics, imaging techniques, diagnosis, and treatment. METHODS: A Pubmed search using the specific key words "LSTV," "lumbosacral transitional vertebrae," and " @entity244 " was performed. The resulting group of manuscripts from our search was evaluated. RESULTS: LSTV are associated with alterations in biomechanics and anatomy of spinal and paraspinal structures, which have important implications on surgical approaches and techniques. LSTV are often inaccurately detected and classified on standard AP radiographs and MRI. The use of whole-spine images as well as geometric relationships between the sacrum and lumbar vertebra increase accuracy. Uncertainty regarding the cause, clinical significance, and treatment of LSTV persists. Some authors suggest an association between LSTV types @entity1643 . Pseudoarticulation between the transverse process and the sacrum creates a "false joint" susceptible to arthritic changes and @entity5040 formation potentially leading to nerve root entrapment. The diagnosis of symptomatic LSTV is considered with appropriate @entity1 history, imaging studies, and diagnostic injections. A positive radionuclide study along with a positive effect from a local injection helps distinguish the transitional vertebra as a significant @entity158 source. Surgical resection is reserved for a subgroup of LSTV @entity1 who fail conservative treatment and whose @entity158 is definitively attributed to the @entity3466 . CONCLUSIONS: Due to the common finding of @entity1643 and the wide prevalence of LSTV in the general population, it is essential to differentiate between symptoms originating from an anomalous psuedoarticulation from other potential sources of @entity1643 . Further studies with larger sample sizes and longer follow-up time would better demonstrate the effectiveness of surgical resection and help guide treatment.
