Vinha André, Bártolo João, Lemos Carolina, Cordeiro Filipa, Rodrigues-Pinto Ricardo
Spine Unit, Porto University Hospital Centre, Porto, Portugal.
Centro Hospitalar Universitário Do Porto, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal.
Eur Spine J. 2022 Dec;31(12):3647-3653. doi: 10.1007/s00586-022-07415-4. Epub 2022 Oct 8.
Lumbosacral transitional vertebra (LSTV) is a congenital anomaly of the lumbosacral junction. Its prevalence is variable in the literature such as its association with low back pain. The aim of this study was to identify the prevalence of LSTV in a southern European population, and its correlation with low back pain.
A retrospective review of 639 thoraco-abdomino-pelvic consecutive CT-scans between January 2019 and November 2020 was performed. The presence of LSTV was classified into type II, III, IV based on Castellvi's classification. To investigate the association with low back pain, Oswestry Low Back Disability Questionnaire (ODI) and the EuroQol-5D-3L questionnaire was applied.
The prevalence of LSTV was 24.9% (142 of 571). 37,3% were type IIb, 31,0% were type IIa, 13,4% were type IIIa, 9.9% were type IIIb and 8.5% were type IV. Individuals with LSTV were more likely to report low back pain and have a higher ODI score (OR:0.392, 95% CI:0.192-0.802, p = 0.010), (OR: 1050, 95% CI: 1029-1072, p < 0.01). Castellvi's type IV showed a significantly higher ODI when compared to type II (OR:1059, 95% CI:1019-1100, p = 0,04). There was no statistical difference in the EuroQol-5D-3L score between two groups (OR:1085, 95% CI: 0.459-2.560, p = 0.852).
This population-based study adds to the literature the prevalence of LSTV in a southern European population. LSTV was associated with low back pain. However, this difference did not translate into a loss of quality life. Type IV was associated with higher functional disability when compared with type II.
腰骶部移行椎（LSTV）是腰骶部连接处的一种先天性异常。其在文献中的患病率各不相同，例如其与腰痛的关联。本研究的目的是确定南欧人群中LSTV的患病率及其与腰痛的相关性。
对2019年1月至2020年11月期间连续的639例胸腹部盆腔CT扫描进行回顾性分析。根据Castellvi分类法，将LSTV的存在分为II型、III型、IV型。为了研究与腰痛的关联，应用了Oswestry腰痛残疾问卷（ODI）和欧洲五维健康量表（EuroQol-5D-3L）问卷。
LSTV的患病率为24.9%（571例中的142例）。37.3%为IIb型，31.0%为IIa型，13.4%为IIIa型，9.9%为IIIb型，8.5%为IV型。患有LSTV的个体更有可能报告腰痛且ODI评分更高（比值比：0.392，95%置信区间：0.192 - 0.802，p = 0.010），（比值比：1050，95%置信区间：1029 - 1072，p < 0.01）。与II型相比，Castellvi IV型的ODI显著更高（比值比：1059，95%置信区间：1019 - 1100，p = 0.04）。两组之间的欧洲五维健康量表（EuroQol-5D-3L）评分无统计学差异（比值比：1085，95%置信区间：0.459 - 2.560，p = 0.852）。
这项基于人群的研究为南欧人群中LSTV的患病率增添了文献资料。LSTV与腰痛相关。然而，这种差异并未转化为生活质量的下降。与II型相比，IV型与更高的功能残疾相关。
