Symptomatic and morphometric analysis of lumbosacral transitional vertebrae: assessments by age and gender

Aim: Lumbosakral transitional vertebrae (LSTV) are anatomical variations where a vertebra exhibits characteristics of both lumbar and sacral vertebrae. This study aims to assess anatomical changes in LSTV patients by measuring intervertebral disc height (IVDh), vertebral foramen anteroposterior diameter (FVAPd), and intervertebral foramen height (FIVh), with consideration of age and gender differences. Material and Methods: This retrospective study included 274 patients diagnosed with LSTV. All MRI images were acquired with a 1.5T MRI machine and a 32-channel lumbar coil. The presence of LSTV, forming the morphological data, was identified from coronal and sagittal reformat images and was classified as either lumbarization or sacralization. Morphometric data (IVDh, FIVh and FVAPd) were acquired from axial, sagittal, and coronal planes using both soft tissue and bone window settings. Results: The mean patient age was 41.6±13.0 years, with a female majority (55.8%). LSTV was predominantly lumbarization (96.4%), with sacralization in the remaining cases. The overall mean FVAPd was 11.2±2.4 mm, mean IVDh was 9.1±1.8 mm, and mean FIVh was 18.8±2.4 mm on the right and 19.1±2.4 mm on the left. IVDh levels were consistent across age groups, while FVAPd values were similar between genders. Patients aged 40 and under had higher FVAPd and FIVh levels, and male patients had higher IVDh and FIVh levels compared to females. Conclusions: The morphometric characteristics of LSTV may vary according to age and gender. Considering these factors in accurately identifying the anatomical variations of LSTV may play a significant role in determining appropriate treatment and management strategies.