Type of Article : Case Report
Year: 2015 | Volume 3 | Issue 3 | Page No. 1285-1288
Date of Publication: 31-08-2015
A CASE REPORT OF A VARIANT OF LUMBO-SACRAL TRANSITION VERTEBRAE: CASTELLVI TYPE IIA SACRALISATION
Subhendu Pandit *1, Monalisa 2, Samrat Sapkota 3, Sushil Kumar 4.
*1 Associate Professor, Dept of Anatomy, Armed Forces Medical College, Pune, Maharastra, India.
2,3 Resident, Dept of Anatomy, Armed Forces Medical College, Pune, Maharastra, India.
4 Professor and Head, Dept of Anatomy, Armed Forces Medical College, Pune, Maharastra, India.
Address: Dr Subhendu Pandit, Associate Professor, Dept of Anatomy, Armed Forces Medical College, Pune 411040, Maharastra, India.
Lumbosacral transitional vertebra (LSTV) are congenital anomalies of the lumbosacral spine causing sacralisation or lumbarisation. Sacralisation has been defined as an abnormality where one of the transverse processes of L5 vertebra may articulate or fuse with the sacrum. The sacralisation has been studied for almost a century for its association with low back pain as “Bertolotti Syndrome”, but there are studies for and against its association. Castellvi in 1984 had propounded a radiographical classification identifying sacralisation in four sub types. Out of this, the Type IIA, is the least prevalent wherein there is a unilateral articulation of the L5 transverse process with the sacral ala. Inspite of the controversy, there is a high association of low back pain with disc degeneration, nerve root compression and degenerative facet joints observed with this condition. It is a widely researched vertebral anomaly for its anatomical, developmental and clinical ramifications.
KEY WORDS : Lumbosacral vertebra, Sacralisation, Low back pain.
- Konin GP, Walz DM. Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR American journal of Neuroradiology 2010;31(10):1778-86.
- Bron JL, Van Royen BJ, Wuisman PI. The clinical significance of lumbosacral transitional anomalies. Acta orthopaedica Belgica 2007;73(6):687-95.
- Manners Smith T. The variability of last lumbar vertebra. University of Cambridge Jan 1909;Vol.XLIII(Third Ser Vol IV):146-159.
- Bertolotti M. Contribute alla conoscenza dei vizi di differenzazione del rachide con speciale reguardo all assimilazione sacrale della v lombare. La Radiologia Medica 1917;4:113–44.
- Castellvi AE, Goldstein LA, Chan DP. Lumbosacral transitional vertebrae and
their relationship with lumbar extradural defects. Spine 1984;9:493–95.
- Bulut M, Uçar BY, Uçar D, Azboy İ, Demirtaş A, Alemdar C et al. Is sacralisation really a cause of low back pain?. ISRN orthopedics 2013.
- Otani K, Konno S, Kikuchi S. Lumbosacral transitional vertebrae and nerve-root symptoms. The Journal of Bone and Joint Surgery 2001;83(8):1137–1140.
- Elster AD. Bertolotti’s syndrome revisited: transitional vertebrae of the lumbar spine. Spine 1989;14:1373–177.
- French HD, Somasundaram AJ, Schaefer NR, Laherty RW. Lumbosacral transitional vertebrae and its prevalence in the Australian population. Global spine journal 2014;4(4):229-32.
- Ucar D, Ucar BY, Cosar Y, Emrem K, Gumussuyu G, Mutlu S, et al. Retrospective cohort study of the prevalence of lumbosacral transitional vertebra in a wide and well-represented population. Arthritis 2013;(2013).
- Paraskevas G, Tzaveas A, Koutras G, Natsis K. Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature. Cases journal 2009;2:8320.
- Chang HS, Nakagawa H. Altered function of lumbar nerve roots in patients with transitional lumbosacral vertebrae. Spine 2004;29(15):1632–1635.
- Magora A, Schwartz A. Relation between the low back pain syndrome and X-ray findings. II. Transitional vertebra (mainly sacralisation). Scandinavian Journal of Rehabilitation Medicine 1978;10(3):135–145.
- Luoma K, Vehmas T, Raininko R, Luukkonen R, Riihimäki H. Lumbosacral transitional vertebra : relation to disc degeneration and low back pain. Spine 2004; 29:200-205.
- Van Tulder MW, Assendelft WJ, Koes BW, Bouter LM. Spinal radiographic findings and nonspecific low back pain. A systematic review of observational studies. Spine 1997;22:427-434.
- Vergauwen S, Parizel PM, Van Breusegem L et al. Distribution and incidence of degenerative spine changes in patients with a lumbo-sacral transitional vertebra. Eur Spine J 1997;6:168-172.
- Erken E, Ozer HTE, Gulek B, Durgun B. The Association Between Cervical Rib and Sacralization. Spine 2002;27(15):1659-64.
Subhendu Pandit, Monalisa, Samrat Sapkota, Sushil Kumar. A CASE REPORT OF A VARIANT OF LUMBO-SACRAL TRANSITION VERTEBRAE: CASTELLVI TYPE IIA SACRALISATION. Int J Anat Res 2015;3(3):1285-1288. DOI: 10.16965/ijar.2015.212