Hanhivaara, Jaakko MDa,b; Määttä, Juhani H. MD, PhDb,c; Karppinen, Jaro MD, PhDb; Niinimäki, Jaakko MD, PhDa,b,c; Nevalainen, Mika T. MD, PhDa,b,c. The Association of Lumbosacral Transitional Vertebrae with Low Back Pain and Lumbar Degenerative Findings in MRI: A Large Cohort Study. SPINE 47(2):p 153-162, January 15, 2022. | DOI: 10.1097/BRS.0000000000004244
The association of lumbosacral transitional vertebrae with low back pain and lumbar degenerative findings in MRI : a large cohort study
|Author:||Hanhivaara, Jaakko1,2; Määttä, Juhani H.2,3; Karppinen, Jaro2;|
1Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
2Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
|Online Access:||PDF Full Text (PDF, 0.4 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe20231030141926
|Publish Date:|| 2023-10-30
Study Design: A cross-sectional study of the Northern Finland Birth Cohort 1966 (NFBC1966).
Objective: To evaluate the association of lumbosacral transitional vertebrae (LSTV) with low back pain (LBP) and associated degenerative findings using magnetic resonance (MR) imaging.
Summary of Background Data: LSTV is a common finding with a prevalence of 10% to 29%. LSTV causes biomechanical alterations leading to accelerated lumbar degeneration. However, its association with degenerative findings on MRI and LBP is unclear.
Methods: One thousand four hundred sixty eight lumbar spine MRI scans from the NFBC1966 acquired at a mean age of 47 years were assessed for the presence of LSTV and degenerative changes. Castellvi classification was utilized to identify LSTV anatomy. Additionally, 100 controls without LSTV were collected. Self-reported LBP with a duration of more than 30 days in the past year was deemed clinically relevant. For the statistical analyses, chi square test, independent samples t test and multinomial logistic regression analyses were used.
Results: LSTV was found in 310 (21.1%) subjects. After adjusting for age, sex, and disc degeneration (DD) sum, subjects with Castellvi type III reported prolonged LBP significantly more frequently than the controls (odds ratio [OR] = 8.9, P = 0.001). We observed a higher prevalence of facet degeneration (FD) at all levels from L3/L4 to L5/S1 in type I, and L3/L4 to L4/L5 in types II–IV. DD was more prevalent at L4/L5 in types II–IV. Disc protrusion/extrusion occurred more frequently at L3/L4 and L4/L5 in type II, and at L3/L4 in type III. Castellvi type II had a higher prevalence of type 1 Modic changes at levels from L3/L4 to L4/L5.
Conclusions: LSTVs were a common finding within this study, and Castellvi type III LSTVs were associated with LBP. Degenerative findings were associated with LSTV anatomy and occurred more commonly above the transitional level.
|Pages:||153 - 162|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
Finnish Cultural Foundation, North Ostrobothnia Regional funds were received in support of this work.
© 2021 Wolters Kluwer Health, Inc. This is a non-final version of an article published in final form in Hanhivaara, Jaakko MDa,b; Määttä, Juhani H. MD, PhDb,c; Karppinen, Jaro MD, PhDb; Niinimäki, Jaakko MD, PhDa,b,c; Nevalainen, Mika T. MD, PhDa,b,c. The Association of Lumbosacral Transitional Vertebrae with Low Back Pain and Lumbar Degenerative Findings in MRI: A Large Cohort Study. SPINE 47(2):p 153-162, January 15, 2022. | DOI: 10.1097/BRS.0000000000004244.