Is Lumbosacral Transitional Vertebrae Associated with Increased Risk of Spondylolisthesis, Vertebral Osteochondrosis and Disc Pathologies?

Congress:

ECR 2020

Poster Number:

C-10451

Type:

Scientific Exhibit

Keywords:

Case-control study, Retrospective, Developmental disease, Congenital, Imaging sequences, MR, Musculoskeletal system, Musculoskeletal spine, Bones, Musculoskeletal, Performed at one institution

Authors:

N. TOKGOZ, P. Kılıç; Ankara/TR

DOI:

10.26044/ecr2020/C-10451

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-10451

Fig. 1: Example of sagittal whole-spine localizer image with half-Fourier acquisition...

Fig. 2: Evaluated last three fully developed disc segments are shown in patients with...

Fig. 3: Pfirrmann grading system for evaluation of disc degeneration (a-e). Grade I:...

Purpose

The role of transitional vertebrae in lumbosacral spondylolisthesis, osteochondrosis and discopathies is still an enigma. Our purpose was to investigate the relationships of them with lumbosacral transitional vertebrae (LSTV).

Methods and materials

After institutional review board approval, 249 patients (145 women and 104 men; age range 19-75; mean age, 48 years) with low back pain and had lumbar MRI including whole-spine localizer were included in this retrospective study. There were normal, sacralization and lumbarization groups with age-matched 83 cases in each group. The last three mobile lumbar segments caudally (M1, M2, M3) were evaluated on MRI in consensus of two radiologists. Meyerding, Modic and Pfirrmann classifications were used in evaluation of spondylolisthesis, vertebral end-plate and disc degeneration,...

Results

A positive correlation was found between age and presence of spondylolisthesis and annular tears in all groups. The grades of Modic, Pfirrmann and disc pathologies were increased with aging, and found more severe in women. Spondylolisthesis at M2 was more common (19.3%) in lumbarized patients. No association was found between LSTV and spondylolisthesis in other levels. At M1, spondylolisthesis was 71.4% anteriorly in sacralized and 75% posteriorly in lumbarized patients. LSTV patients did not show higher Modic and Pfirrmann grades compared to normal group. Also,...

Conclusion

Only at M2, lumbarization was found to increase the risk of spondylolisthesis. Otherwise, adjacent cephalic segment to transitional vertebrae and other levels were not found prone to spondylolisthesis, osteochondrosis and disc pathologies. There is still a need for prospective studies in a larger patient group to evaluate the biomechanical effects of LSTV on lumbosacral degeneration and low-back pain.

Personal information and conflict of interest

P. Kılıc; Ankara/TR - nothing to disclose N. Tokgoz; Ankara/TR - nothing to disclose

References

1. Habibi, Z., et al., Lumbosacral sagittal alignment in association to intervertebral disc diseases. Asian Spine J, 2014. 8(6): p. 813-9. 2. Pfirrmann, C.W., et al., Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976), 2001. 26(17): p. 1873-8. 3. Farshad-Amacker, N.A., et al., Interreader and intermodality reliability of standard anteroposterior radiograph and magnetic resonance imaging in detection and classification of lumbosacral transitional vertebra. Spine J, 2014. 14(8): p. 1470-5. 4. de Bruin, F., et al., Prevalence and clinical significance of lumbosacral...