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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C. y de la Sociedad Iberolatinoamericana de Columna. SILACO.

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2026, Number 3

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Cir Columna 2026; 4 (3)

Prevalence of transitional vertebrae in patients with chronic low back pain in a trauma and orthopedic referral hospital

Pérez-Rojas S, Lara-Díaz EI, Quiroz-Williams J, Gaytán-Fernández S, Rodríguez-Palacios CL, Portillo-Gutiérrez S, Barragán-Hervella RG, De IÁ

Language: Spanish
References: 22
Page: 222-226
PDF size: 195.69 Kb.


ABSTRACT

Introduction: low back pain is the main symptom of multiple lumbar spine pathologies. It is generally associated with chronic degenerative conditions. Sometimes, there is no apparent triggering factor. Of these causes, the presence of a lumbosacral abnormality is the predisposing factor. Congenital anomalies that have been associated with low back pain include transitional lumbosacral vertebrae (TLSV) and spina bifida occulta. TLSV has been mentioned as a possible cause of degenerative spondyloarthrosis due to increased stress on the adjacent vertebra (adjacent segment disease). Material and methods: an analytical and retrospective observational study was conducted in patients who presented with chronic non-traumatic low back pain and for which a lumbar spine CT was performed, in those aged > 18 years, from January 1 to December 31, 2024. Axial and sagittal CT sections were reviewed, in addition to 3D reconstructions, with 3 mm slices. A deliberate search for VTLS was performed, and the Castellvi classification was applied to determine the anatomical variant. Measures of central tendency and dispersion were used for statistical analysis. Results: a sample of 823 patients were reviewed. Of these, 57.6% were male and 42.4% female. 84.9% presented low back pain, and 15.1% radiculopathy. Only 15% of patients presented LSTV. Of these, according to the Castellvi classification, the most frequent types were IA (25.41%, n = 31), IB (23.77%, n = 29), and IIA (25.41%, n = 31). Conclusion: the prevalence of LSTV was 15% in the population with chronic low back pain.


REFERENCES

  1. Pérez-Castro D, Rojas-Del Campo LH, Hernández-Tápanes S, Bravo-Acosta T, Bravo-Hernández. Actualización sobre lumbalgias mecánicas agudas. RCMFR. 2011; 3: 1-13.

  2. Rocha J. Anomalías radiológicas lumbosacras en jóvenes masculinos asintomáticos. Arch Salud Sin. 2010; 4: 5-8.

  3. Cuenca-González C, Cristóbal-Durán M, Estay-Girardi JA, García-Mian L, Garvin-Ocampos L. Síndrome de Bertolotti: dolor lumbar crónico de características mecánicas por megaapófisis transversa. Semergen. 2016; 42: 122-124.

  4. Konin GP, Walz DM. Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJN. 2010; 31: 1778-1786.

  5. Nardo L, Alizai H, Virayavanich W, Liu F, Hernandez A, Lynch JA, et al. Lumbosacral transitional vertebrae: Association with low back pain. Radiology. 2012; 265: 497-503.

  6. Chavarría Solís J. Lumbalgia: causas, diagnóstico y manejo. Rev Med Costa Rica Centroam. 2014; 71: 447-454.

  7. De Almeida DB, Mattei TA, Sória MG, Prandini MN, Leal AG, Milano JB, et al. Transitional lumbosacral vertebrae and low back pain: Diagnostic pitfalls and management of Bertolotti's syndrome. Arq Neuropsiquiatr. 2009; 67: 268-272.

  8. Jancuska JM, Spivak JM, Bendo JA. A review of symptomatic lumbosacral transitional vertebrae: Bertolotti's syndrome. Int J Spine Surg. 2015; 9: 42.

  9. Gopalan B, Yerramshetty JS. Lumbosacral transitional vertebra-related low back pain: Resolving the controversy. Asian Spine J. 2018; 12: 407-415.

  10. Moreno García MS, Baltanás Rubio P. Megaapósis transversa: síndrome de Bertolotti. Rev Argent Reumatol. 2016; 27: 47.

  11. Moreno García MS, del Río-Martínez PS, Baltanás Rubio P, Cía Blasco P. Síndrome de Bertolotti: a propósito de un caso. Rev Colomb Reumatol. 2016; 23: 200-203.

  12. Murlimanju BV, Prabhu LV, Pai MM, Ganeshkumar C, Sarvepalli A. Lumbosacral transitional vertebrae: a case report and clinical implications. Int J Morphol. 2011; 29: 1123-1125.

  13. Neelakantan S, Anandarajan R, Shyam K, Philip B. Multimodality imaging in Bertolotti's syndrome: an important cause of low back pain in young adults. BMJ Case Rep. 2016; 2016: bcr2016217121. doi: 10.1136/bcr-2016-217121.

  14. Díaz-Flores MA. Prevalencia de anomalías de transición lumbosacra y su correlación con lumbalgia en la UMAE de Veracruz [Tesis]. México: Universidad Veracruzana; 2019. Disponible en: https://cdigital.uv.mx/server/api/core/bitstreams/73fad0b6-5f16-439e-80d0-eac132da6311/content

  15. Bulut M, Ucar BY, Ucar D, Azboy I, Demirtas A, Alemdar C, et al. Is sacralization really a cause of low back pain? ISRN Orthop. 2013; 2013:839013.

  16. Ravikanth R, Majumdar P. Bertolotti's syndrome in low-backache population: Classification and imaging findings. Tzu Chi Med J. 2019; 31: 90-95.

  17. Kara GK, Kavak H. Does lumbosacral transitional vertebrae cause low back pain? J Turk Spinal Surg. 2020; 31: 234-238.

  18. Guerrero-Julca MN. Panorámica de columna lumbosacra por resonancia magnética para determinar anomalías de transición lumbar Lima-2019 [Tesis]. Lima, Perú: Universidad Nacional Federico Villarreal; 2020. Disponible en: https://repositorio.unfv.edu.pe/bitstream/handle/20.500.13084/4682/GUERRERO%20JULCA%20MICXY%20NELLY%20-%20TITULO%20PROFESIONAL.pdf?sequence=1

  19. French HD, Somasundaram AJ, Schaefer NR, Laherty RW. Lumbosacral transitional vertebrae and its prevalence in the Australian population. Global Spine J. 2014; 4: 229-232.

  20. Khairnar KB, Rajale MB. Sacralization of lumbar vertebra. Indian J Basic Appli Med Res. 2013; 6: 510-14.

  21. Jeon JY, Jeong YM, Lee SW, Kim JH, Choi HY, Ahn Y. The termination level of the dural sac relevant to caudal epidural block in lumbosacral transitional vertebrae: a comparison between sacralization and lumbarization groups. Pain Physician. 2018; 21: 73-82.

  22. Rajadurai J, Likhit C, Kumar S, Charles V. Can sacralization of lumbar vertebra be a predictor of future spinal degeneration and what are the implications for clinical practice? Res J Med. 2024; 18: 737-747.




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