What is a transitional L5 vertebra?

Background context: Lumbosacral transitional vertebrae (LSTVs) are a congenital vertebral anomaly of the L5-S1 junction in the spine. This alteration may contribute to incorrect identification of a vertebral segment, leading to wrong-level spine surgery and poor correlation with clinical symptoms.

What does transitional L5 segment mean?

“Transitional vertebra” is a fairly common spinal deformity, in which the lowest vertebrae of the spine, the fifth lumbar vertebra, is partially fused to the top of sacrum. This odd hybrid bone is not a proper lumbar vertebra, and certainly not a sacral segment either — thus, it is a “transitional” vertebra.

What does sacralized L5 mean?

Sacralization is a common irregularity of the spine, where the fifth vertebra is fused to the sacrum bone at the bottom of the spine. The fifth lumbar vertebra, known as L5, may fuse fully or partially on either side of the sacrum, or on both sides. Sacralization is a congenital anomaly that occurs in the embryo.

What does transitional lumbosacral vertebra mean?

Lumbosacral transitional vertebrae (LSTV) are congenital spinal anomalies, in which an elongated transverse process of the last lumbar vertebra fuses with varying degree to the “first” sacral segment.

How common is lumbosacral transitional vertebrae?

LSTVs are congenital spinal anomalies defined as either sacralization of the lowest lumbar segment or lumbarization of the most superior sacral segment of the spine. LSTVs are common in the general population, with a reported prevalence of 4\%–30\%.

Is lumbar spine the same as lumbosacral spine?

A lumbosacral spine x-ray is a picture of the small bones (vertebrae) in the lower part of the spine. This area includes the lumbar region and the sacrum, the area that connects the spine to the pelvis. This is the spine and the sacrum with the cervical (neck), thoracic (mid-back), and lumbar (lower back) vertebra.

What causes transitional lumbosacral anatomy?

Lumbosacral transitional vertebra (LSTV) is a congenital anomaly of the spine that arises because of mutations in the Hox genes, giving rise to sacralization (fifth lumbar vertebra shows assimilation to the sacrum) and lumbarization (first sacral vertebra shows lumbar configuration).

What are the symptoms of L5 nerve damage?

Compression or inflammation of the L5 and/or S1 spinal nerve root may cause radiculopathy symptoms or sciatica, characterized by:

• Pain, generally felt as a sharp, shooting, and/or searing feeling in the buttock, thigh, leg, foot, and/or toes.
• Numbness in the foot and/or toes.

What is the sacrum?

The sacrum is a shield-shaped bony structure that is located at the base of the lumbar vertebrae and that is connected to the pelvis. The sacrum forms the posterior pelvic wall and strengthens and stabilizes the pelvis. The coccyx provides slight support for the pelvic organs but actually is a bone of little use.

What vertebrae are lumbosacral?

The spine is composed of 33 interlocking bones called vertebrae. The lumbosacral region of the spine consists of 5 lumbar vertebrae and the sacrum (5 bones joined together).

What is a MRI spine lumbar and sacral?

A lumbar MRI specifically examines the lumbar section of your spine — the region where back problems commonly originate. The lumbosacral spine is made up of the five lumbar vertebral bones (L1 thru L5), the sacrum (the bony “shield” at the bottom of your spine), and the coccyx (tailbone).

How do you treat Lumbarization?

How is Lumbarization Treated? In the first instance, over-the-counter painkillers and non-steroidal anti-inflammatory drugs may be helpful. However, if they do not help, nerve block injections with the use of a local anesthetic may provide some temporary relief.

What are lumbosacral transitional vertebrae?

Lumbosacral transitional vertebrae (LSTV) are congenital spinal anomalies, in which an elongated transverse process of the last lumbar vertebra fuses with varying degree to the “first” sacral segment.

What does a sacralized L5 transitional vertebral body look like on CT?

Sagittal CT image demonstrates “wedging” of a sacralized L5 transitional vertebral body ( white arrow ). A, Note the decreased height between the sacralized L5 vertebral body and S1 ( black arrow) compared with the normal height typically seen at this level.

What is the Castellvi classification of lumbosacral transitional anatomy?

The Castellvi classification is commonly used to classify transitional anatomy, Ferguson projection (AP lumbar spine radiograph, 30° cranial tilt) and lateral projection have been traditionally used as the best method for identification of lumbosacral transitional vertebra, although this has been largely replaced by cross-sectional imaging.

Which vertebrae are considered lumbar type?

After T12, the vertebrae are considered lumbar-type and the 24 th vertebra is designated L5 and the 25 th vertebra is designated S1, even in cases of lumbosacral transitional anatomy (considered partially or completely sacralized L5 or lumbarized S1) rather than omitting L5 or designating an L6 vertebra 5. 1.