Lumbosacral Transitional Vertebra: Cause of Lower Back Pain?

There is conflicting research as to whether a condition known as a lumbosacral transitional vertebra (LSTV) is associated with lower back pain. If it is, diagnosis of the condition could be crucial to identifying appropriate back pain treatment and could help avoid back surgery failure.

The lumbosacral transitional vertebra is present when there is an abnormality between the lowest lumbar vertebra (L5) and the topmost sacral vertebra (S1). In a typical spine, there are five distinct lumbar vertebrae and five distinct sacral segments, the latter of which are fused together to form a triangular bone at the base of the spine. When LSTV is present, the lumbosacral junction is abnormal.

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There are four different types of LSTV:

I. One or both transverse processes are enlarged (the transverse process is a bony projection on each side of a vertebra)

II. One or both transverse processes form a joint between the sacral and lumbar vertebrae

III. Complete fusion of L5 and S1 on one or both sides

IV. Type II on one side and type III on the other (abnormal joint on one side, complete fusion on the other)

New research may help resolve the debate as to whether or not LSTV is a factor in back pain. Researchers took radiographic imaging tests of the pelvises of 5,860 individuals to determine the prevalence of various types of the lumbosacral transitional vertebra and assess for any increased incidence of back pain among those with a form of the condition. They found that 15.8% of the participants had some form of LSTV.