The Impact of Lumbosacral Transitional Vertebra on Long-Term Surgical Outcome of Adjacent Single-Level Lumbar Discectomy

Introduction The lumbosacral transitional vertebra (LSTV) theoretically offloads the inferior intervertebral disc and may reciprocally load up the relevant adjacent disc. In this study, we evaluate the influence of LSTV on clinical outcomes of adjacent discectomy in young adults with lumbar disc herniation (LDH). Methods This retrospective study included two groups. Group A consisted of 32 LDH patients with LSTV (16 males and 16 females), and Group B included 167 LDH patients without LSTV (89 males and 78 females). All patients underwent single-level discectomy at the adjacent level to LSTV and were followed for a minimum of 24 months post-surgery. The diagnosis of LSTV was based on radiography and computed tomography (CT) scanning performed preoperatively for all patients. Outcome measurements were performed with pain assessment at each follow-up visit using a visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and recurrence rate. Results At 24 months after discectomy, the mean VAS scores for low back pain (LBP) and leg pain and ODI scores showed no significant differences between the two groups. Recurrence occurred in 25 patients (15%) in Group A and in 4 patients (12.5%) in Group B. Conclusions In the patients with LDH who underwent microlumbar discectomy, after a mean follow-up period of 48.4 ± 13.7 months, we could not find any significant difference in terms of pain, disability, patient satisfaction, or recurrence rate between the group with versus without LSTV.