Semptomatik hastalarda lomber BT’de lumbosakral transisyonel vertebra prevalansı ve eşlik eden dejeneratif görüntüleme bulguları

Öz

Amaç: Bu çalışmanın amacı, bel ağrısı nedeniyle lomber BT çekilen hastalarda lumbosakral transisyonel vertebra (LSTV) yaygınlığını ve alt tiplerinin dağılımını değerlendirmek ve ilişkili dejeneratif değişiklikleri araştırmaktır. Gereç ve yöntem: Ocak 2023 ile Nisan 2024 arasında bel ağrısı nedeniyle lomber BT çekilen 1.035 hastanın retrospektif incelemesi yapıldı. LSTV'li 133 hasta belirlendi ve Castellvi sınıflandırmasına göre sınıflandırıldı. Psödoartiküler dejenerasyon, disk daralması, faset eklem artropatisi, foraminal stenoz ve skolyoz dahil olmak üzere LSTV seviyesindeki dejeneratif değişiklikler değerlendirildi. Bulgular: LSTV hasta popülasyonunun %12,85'inde saptandı. Psödoartiküler dejenerasyon vakaların %67,7'sinde gözlendi ve Tip II ve IV'te Tip I (%60) ve III (%0) ile karşılaştırıldığında önemli ölçüde daha yüksek oranlar (%98,2 ve %100) görüldü. Sefalad disk daralması Tip III'te (%90) en yaygındı. Faset eklem artropatisi vakaların %85,7'sinde gözlenirken, foraminal stenoz yalnızca Tip II'de (%9,8) bulundu. Skolyoz Tip II'de (%50,9) ve IV'te (%50) Tip I (%24) ve III'e (%4,5) göre daha yaygındı. Psödoartiküler dejenerasyon, disk daralması, foraminal stenoz ve skolyozda istatistiksel olarak anlamlı farklılıklar gözlendi. Sonuç: LSTV bel ağrısı hastalarında yaygındır. Tip II ve IV'te psödoartikülasyon seviyesinde erken dejenerasyon görülür ve bu özellikle genç ve orta yaşlı bireylerde semptomlara katkıda bulunabilir. Dejeneratif hipertrofiye bağlı sinir kökü sıkışması Tip II'de yaygındır ve semptomatik vakalarda görüntüleme yöntemleriyle LSTV bölgesinin dikkatli bir şekilde incelenmesini gerektirir.

Anahtar Kelimeler

• Lumbosakral transisyonel vertebra
• bilgisayarlı tomografi
• psödoartikülasyon
• bel ağrısı

Prevalence of lumbosacral transitional vertebra on lumbar CT and associated degenerative imaging findings in symptomatic patients

Öz

Purpose: This study aimed to assess the prevalence and distribution of lumbosacral transitional vertebra (LSTV) subtypes in patients with low back pain and investigate associated degenerative changes using lumbar CT imaging. Material methods: A retrospective review of 1.035 patients who underwent lumbar CT for low back pain between January 2023 and April 2024 was conducted. 133 with LSTV were identified and classified according to the Castellvi classification. The degenerative changes at the LSTV level, including pseudoarticular degeneration, disc narrowing, facet joint arthropathy, foraminal stenosis, and scoliosis, were evaluated. Results: LSTV was present in 12.85% of the patient population. Degeneration at the pseudoarticulation was observed in 67.7% of cases, with Types II and IV showing significantly higher rates (98.2% and 100%) compared to Types I (60%) and III (0%). Disc narrowing at the cephalad level was most common in Type III (90%). Facet joint arthropathy was observed in 85.7% of cases, while foraminal stenosis was only found in Type II (9.8%). Scoliosis was more prevalent in Types II (50.9%) and IV (50%) than in Types I (24%) and III (4.5%). Statistically significant differences were observed in pseudoarticular degeneration, disc narrowing, foraminal stenosis, and scoliosis. Conclusion: LSTV is common in low back pain patients, with Types II and IV showing early degeneration at the pseudoarticulation level that may contribute to symptoms, particularly in young and middle-aged individuals. Nerve root compression due to degenerative hypertrophy is common in Type II and requires careful examination of the LSTV region with imaging methods in symptomatic cases.

Anahtar Kelimeler

• Lumbosacral transitional vertebra
• computed tomography
• pseudoarticulation
• low back pain

Kaynakça

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