Kuoppala Anttoni, Määttä Juhani, Hanhivaara Jaakko, Niinimäki Jaakko, Nevalainen Mika
University of Oulu, Oulu, Finland.
Oulu University Hospital, Oulu, Finland.
Int Orthop. 2025 Aug 13. doi: 10.1007/s00264-025-06637-7.
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.
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.
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.
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.
腰骶部移行椎（LSTV）是一种与腰椎退变相关的常见异常。本研究的目的是使用屈伸位X线片研究有无LSTV的受试者的腰椎活动度。
在这项回顾性单中心研究中，我们纳入了2005年至2023年间进行过屈伸位X线片和腹部盆腔CT检查的受试者。LSTV根据Castellvi分类法进行分级，腰椎活动度通过全腰椎前凸、椎间盘楔变角度、节段性前凸角度以及屈伸位X线片上的活动范围（RoM）进行评估。采用独立样本t检验和Mann-Whitney U检验进行统计分析。
研究组包括Castellvi II-IV型（n = 29，平均年龄59.1岁，62%为男性），对照组为20名无LSTV的受试者（平均年龄65.1岁，35%为男性）。研究组腰椎的总体RoM小于对照组（33.5°±14.2° vs. 38.3°±12.1°，p = 0.23）。在L5/S1移行水平，全腰椎活动度的分布在研究组为10.7%，在对照组为22.2%（p = 0.002）；同样，在评估椎间盘楔变角度时，研究组的伸展和RoM低于对照组，分别为8.7±4.8° vs. 12.9±4.7°（p = 0.002）和3.3±3.8° vs. 7.3±3.8°（p < 0.001）。节段性前凸测量结果相同：分别为15.7±5.6° vs. 23.1±4.5°（p < 0.001）和3.3±5.5° vs. 8.3±3.8°（p < 0.001）。两组之间上腰椎水平腰椎活动的相对分布没有统计学上的显著差异。
LSTV降低了L5/S1水平的腰椎活动度，但并未增加上腰椎水平的相对活动度。活动度的总体代偿似乎在上腰椎节段均匀分布，而不会过度代偿至相邻上节段。
