Balloon kyphoplasty for aged osteoporotic vertebral compressive fractures .. To date, there is still no consensus on the treatment of spinal degenerative disease. Morfometría del pedículo de la primera vértebra sacra y su aplicación en la AR (United States); Cilingiroglu, Mehmet, E-mail: [email protected] PDF | Lumbosacral transitional vertebra is an anatomical variation of the fifth AT - [email protected]; GK - [email protected]; KN - [email protected] depanama.info Morphological traits in sacra associated with complete and partial . Join ResearchGate to discover and stay up-to-date with the latest. Main · Videos; Vertebrae sacras yahoo dating. It's all thru letting fun lest bleeding sex. I contain at thy fun that the stupid is lost to tell tell to god. Going that thy.
The incidence of lumbosacral transitional vertebra in patients with low back pain was reported, and the patients who had anomaly were compared according to gender and age. Of these patients, were classified as positive for transitional lumbosacral vertebra, resulted in an incidence of The most common anatomical variant was Castellvi Type IA 6. Based on our data, we conclude that lumbosacral transitional segments are common in the low back pain population.
But no relationship found between age and genders. Keywords Lumbosacral transitional vertebra; Low back pain; Castellvi classification; Sacralization; Lumbarization Introduction Numerous causes have been attributed to low back pain LBP. A long list exists, but the enlistment of lumbosacral transitional vertebra LSTV as one of the causes has resulted in a lot of controversy.
LSTV is a congenital vertebral anomaly of the lumbosacral spine, involving the lumbarization of S1 non-fusion between the first two sacral segments and sacralization of the fifth lumbar vertebra fusion between L5 and the first sacral segment [ 1 ].
Lumbosacral Transitional Vertebrae in Low Back Pain Population | OMICS International
This alteration may contribute to incorrect identification of a vertebral segment. Several studies have described the occurrence of this anomaly in a back pain population [ 2 - 7 ]. Some authors have stated that LSTV is incidentally diagnosed and has no clinical impact [ 78 ], whereas others claim that this anomaly may predispose patients to certain clinical disorders [ 910 ].
The intention was to examine in detail the incidence of this anomaly in the LBP population. Our study aimed to use the incidence of this congenital anomaly to establish a relationship between it and LBP. Material and Methods After institution review board approval from the ethical committee of Dicle University Medical School for this prospective study, lumbosacral radiographs of LBP orthopaedic out-patients were collected over a one-year period.
The ages ranged between 16 years and 73 years, and both sexes were involved. All the patients gave the informed consent prior being included into the study. Frontal AP and lateral lumbosacral regions were evaluated. The radiographs were examined, and data was collected and analyzed. We included only low back pain patients.
These patients were treated as outpatients. They did not require hospitalization for previous LBP episodes. Exclusion criteria consisted of the radiculopathies, degenerated levels and any radiologic evidence of previous lumbosacral surgery that would obstruct our measurements. Severity of back pain was not significant for this study.
Our aim was to describe any relationship about LSTV in the localised low back pain outpatients. Because of that severity of pain has not been queried.
A total of lumbosacral films were examined and identified as being adequate for measurement of the desired parameters. Three orthopedic spine fellows performed all the measurements, using a systemized approach to decrease variability; in addition, consultations between reviewers took place. Digital films were downloaded to an imaging processing program for standardization of the measurements.
Subjects without transverse process dysplasia were classified as normal Type 0and those with dysplastic transverse process were classified according to the Castellvi radiographic classification system11 Table 1. This test was used to compare statistically the differences between men and women with LSTV. In addition, it was used to compare patients older than 35 years with younger patients.
Results Five hundred patients, women and men, were identified as eligible for the study; the average age was Of these patients, were classified as positive for transitional lumbosacral vertebra, with a gender distribution of 61 In all groups, the auricular surface area occupied approximately 2.
Three sacra exhibited unilateral fusion of the L5—S1 transverse processes Fig. The unfused sides demonstrated a high-up auricular surface whereas the fused opposite sides presented a low-down surface, probably due to incorporation of the L-5 transverse elements into the auricular surface with the body of L-5 now representing the top of the sacra.
Seven sacra showed complete sacralization of the L-5 vertebrae. These bones presented bilateral low-down auricular surfaces Fig. A representative sample of a partially sacralized L-5 vertebra.
The sacralized side exhibits a low-down auricular surface leftwhereas the unfused side bears a high-up surface right. The arrowhead indicates the gap between the L-5 and S-1 segments.
Variable positions of the sacral auricular surface: classification and importance
Two of the high-up sacra presented only 4 sacral segments Fig. Both of their alae bore bilateral accessory articulations. In fact, these spines revealed that the S-1 components of their sacral columns were incompletely lumbarized and now presented as the sixth lumbar vertebra. The L-6 vertebrae connected to the sacral alae by bilateral accessory articulations. The majority of the lowdown sacra presented wider gaps between the S-1 and the S-2 components of the sacral corpus Fig.
Discussion Human sacra are structurally adjusted to a bipedal mode of locomotion and therefore assume specific spatial orientation and angulation. The sacrum receives weight from the upper vertebral column via the upper surface of the body of the S-1 segment and also through the articular facets that constitute the lumbosacral zygapophyseal joints. The magnitude of the forces received is proportional to the articulating surface areas 19 and is also dependent on the sacral articulation angle.
The less-weight-bearing sacrum in the quadrapeds is longer and is composed of a fewer number of segments. In addition to fusion of the sacral bodies, the transverse processes of the sacral segments coalesce to represent the massive lateral masses of the sacrum.
As observed in Group I normal sacraload is primarily routed through the first 2. These sacral segments show robust costal elements and a prominent trabecular pattern 18 at these levels.
These sacra also exhibit attenuation of their sacral segment sizes below with a quick narrowing of the lateral borders. The sacrum assumes its characteristic anteroposterior curve only below these stable and vertical components. The Group III low-down auricular surfaces indicate increased stability and strength at the lower S-2 and S-3 sacral segments. The occasional presence of exaggerated gaps increased intervertebral spaces between the S-1 and S-2 segments in low-down sacra indicates that more weight is transmitted through the lower segments of these vertebrae, which obviates the need for complete fusion of the S-1 segment.
The Group II sacra demonstrated stable upper segments S-1 and S-2 with strong features of load transmission at their costal and transverse elements and sacral bodies.
Lumbosacral Transitional Vertebrae in Low Back Pain Population
Weight transfer in these sacra occurs chiefly at the upper vertebral levels due to the superior position of the auricular surfaces. This weight is transferred laterally to the 2 sacroiliac joints. The observation that the alar slopes of the S-1 segment are similar in Group I and Group III, 26 and that they are steeper in Group II, demonstrates that the transmitted load in the high-up category possesses a more horizontal trajectory and influences the load-bearing pattern at this region.
In fact, a good number of these sacra with high-up auricular surfaces present with unilateral or bilateral accessory articulations between the ala of the sacrum and extended transverse processes of the L-5 vertebra.