Lumbosacral transitional vertebra alters the mobility of the lumbar spine on flexion-extension radiographs.

IF 2.6 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-10-01 Epub Date: 2025-08-13 DOI:10.1007/s00264-025-06637-7

Anttoni Kuoppala, Juhani Määttä, Jaakko Hanhivaara, Jaakko Niinimäki, Mika Nevalainen

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引用次数: 0

Abstract

Purpose: Lumbosacral transitional vertebra (LSTV) is a common anomaly linked to the degeneration of the lumbar spine. The aim of this work was to study lumbar spine mobility in subjects with and without LSTV using flexion-extension radiographs.

Methods: In this retrospective single-center study, we identified subjects with flexion-extension radiographs and abdominopelvic CTs performed between years 2005-2023. LSTVs were graded according to Castellvi classification, and lumbar mobility evaluated through total lumbar lordosis, disc wedging angles, segmental lordosis angles, and range-of-motion (RoM) from the flexion-extension radiographs. Independent samples t-test and Mann-Whitney U-test were used for statistical analyses.

Results: The study group comprised Castellvi types II-IV (n = 29, mean age 59.1 years, 62% males) and control group 20 subjects without LSTV (mean age 65.1 years, 35% males). The study group presented a smaller overall RoM of lumbar spine than controls (33.5°±14.2° vs. 38.3°±12.1°, p = 0.23). Distribution of total lumbar mobility differed in transitional L5/S1-level being 10.7% with study group and 22.2% with controls (p = 0.002); similarly, assessing disc wedging angles, extension and RoM were lower with study group than controls being 8.7 ± 4.8° vs. 12.9 ± 4.7° (p = 0.002) and 3.3 ± 3.8° vs. 7.3 ± 3.8° (p < 0.001), respectively. Same results were seen with segmental lordosis measurements: 15.7 ± 5.6° vs. 23.1 ± 4.5° (p < 0.001) and 3.3 ± 5.5° vs. 8.3 ± 3.8° (p < 0.001), respectively. There were no statistically significant differences of relative distribution of lumbar motion at the upper lumbar levels between the groups.

Conclusions: LSTV decreases mobility of the lumbar spine in the L5/S1-level but does not increase relative motion at the upper lumbar levels. The overall compensation of mobility seems to distribute equally throughout the superior lumbar segments and not excessively to the superior adjacent level.

查看原文本刊更多论文

腰骶过渡椎体在屈伸x线片上改变腰椎的活动度。

目的：腰骶过渡椎体（LSTV）是一种与腰椎退变有关的常见异常。本研究的目的是通过屈伸x线片研究LSTV患者和非LSTV患者的腰椎活动度。方法：在这项回顾性单中心研究中，我们确定了2005-2023年间进行屈伸x线片和腹部骨盆ct检查的受试者。根据Castellvi分级对LSTVs进行分级，并通过腰椎前凸度、椎间盘楔入角、节段性前凸角和屈伸x线片的活动范围（RoM）评估腰椎活动度。采用独立样本t检验和Mann-Whitney u检验进行统计分析。结果：研究组包括Castellvi II-IV型患者29例，平均年龄59.1岁，男性62%；对照组无LSTV患者20例，平均年龄65.1岁，男性35%。研究组腰椎的整体RoM小于对照组（33.5°±14.2°vs. 38.3°±12.1°，p = 0.23）。在过渡性L5/ s1水平上，研究组的腰椎总活动度分布为10.7%，对照组为22.2% (p = 0.002)；同样，评估椎间盘楔入角、伸度和RoM，研究组比对照组低，分别为8.7±4.8°比12.9±4.7°（p = 0.002）和3.3±3.8°比7.3±3.8°(p结论：LSTV降低了L5/ s1水平腰椎的活动性，但不增加上腰椎水平的相对活动度。活动的整体代偿似乎均匀分布于上腰椎节段，而不过度分布于上邻节段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.