LUMBOSACRAL TRANSITIONAL VERTEBRAE AND ITS CLINICAL SIGNIFICANCE

Abstract

Background: The human sacrum is a wedge shaped bone formed by fused five sacral vertebrae having four pairs of sacral foramina and forms the postero-superior wall of the bony pelvis. Lumbosacral transitional vertebra (LSTV) is a congenital anomaly which involves either the sacralization of the lowest lumbar and first coccygeal vertebra or lumbarization of uppermost sacral vertebra. These vertebral bodies demonstrate varying morphology, ranging from broadened transverse processes to complete fusion.

Material and methods: This study was carried out on 100 dry human sacra (70 male and 30 female) from Department of Anatomy, United Institute of Medical Sciences, UP, India. Morphological study was done on the sacrum and classified as per Castellvi’s classification.

Result: We have highlighted 6 cases of LSTV out of 100 sacrum. Out of 6, 1 sacrum showed simultaneous sacralisation of 1^st coccygeal vertebrae and incomplete lumbarisation of  1^st sacral  vertebrae, 4 sacrum showed complete sacralisation of 5^th lumbar vertebrae and 1 sacrum showed complete lumbarisation of  1^st sacral  vertebrae.

Conclusion: Total incidence of LSTV was observed to be 6% in the present study. Obstetricians, radiologists, anesthetists, neurologists and orthopedic surgeons must know about the existence of this variation to be able to correctly investigate, diagnose and treat the patients presenting with unusual signs and symptoms. Also the awareness of this possible congenital anomaly is important before any spinal surgery to avoid the incorrect numbering of vertebrae and consequently wrong level spinal surgery.