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Neurospine > Volume 17(1); 2020 > Article |
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LSTV type† | Subtype | Anatomical criteria | Prevalence |
---|---|---|---|
Type I | Unilateral (Ia) | Transverse process(es)‡ ≥ 19 mm (craniocaudal dimension) | ~40% |
Bilateral (Ib) | |||
Type II | Unilateral (IIa) | Di-arthrodial joint: transverse process(es) with the sacral ala/e | - |
Bilateral (IIb) | |||
Type III | Unilateral (IIIa) | Complete osseous fusion: transverse process(es) to the sacral ala/e | ~11.5% |
Bilateral (IIIb) | |||
Type IV | - | Unilateral type II transition with a contralateral type III | ~5.25% |
The overall LSTV prevalence of ranges between 4.0% to 35.9% [10].
† Castellvi classification does not distinguish lumbarization (separation of the upper sacral segment) and sacralization (addition of L5 as the upper sacral segment) of the lumbar spine while considering the lumbosacral junction. The biomechanical implications of the disparity in the number of sacral segments in these 2 conditions thus get overlooked in this classification.
‡ Craniocaudal dimension of the transverse process at the lumbosacral junction. Castellvi classification does not specify if the transverse processes belong to an L5 vertebra (L5–S1 accessory articulation), L4 vertebra (in sacralization), or L6 vertebra (in lumbarization) [12].
Variable | Complete lumbarization (4 segments) | Incomplete lumbarization | Normal (5 segments) | Accessory articulation | Incomplete sacralization | Complete sacralization (6 segments) | |||
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Linear dimension (mm) | |||||||||
Sacral height | 90.78* ± 15.17 | - | 105.37 ± 15.32 | 105.05 ± 10.24 | 92.34 ± 9.39 | - | 102.14 ± 12.05 | 114.67 ± 12.4 | |
Auricular surface height | 59.55 ± 5.16 | 59.6† ± 4.03 | 61.7‡ ± 4.9 | 61.15 ± 8.16 | 59.53 ± 6.96 | 58.4† ± 3.04 | 63.09‡ ± 1.02 | 62.22 ± 4.3 | |
Inter facet distance | 47.35 ± 5.66 | - | 47.73 ± 11.45 | 52.12 ± 4.34 | 47.12 ± 5.84 | - | 45.13 ± 3.94 | 46.55 ± 4.34 | |
Inter auricular distance | 101.53 ± 9.02 | - | 94.02 ± 15.63 | 102.79 ± 10.09 | 100.22 ± 8.83 | - | 101.43 ± 6.21 | 98.24 ± 8.83 | |
Alar width bilateral | 60.98 ± 4.9 | - | 48.28* ± 11.93 | 56.45 ± 3.47 | 58.73 ± 0.87 | - | 55.04 ± 1.76 | 51.39 ± 2.84 | |
S1 body width | 40.55* ± 4.12 | - | 45.74 ± 3.7 | 46.34 ± 6.62 | 41.49 ± 7.96 | - | 46.39 ± 4.45 | 46.85 ± 5.99 | |
Facet depth | 13.25 ± 5.46 | - | 14.14 ± 2.35 | 15.24 ± 2.9 | 12.33 ± 2.79 | - | 14.33 ± 3.35 | 16.58 ± 2.76 | |
Surface area (cm2) | |||||||||
Auricular surface area | 9.75 ± 1.24 | 8.03†* ± 1.09 | 9.14‡ ± 1.19 | 10.36 ± 1.86 | 10.56 ± 2.33 | 8.53† ± 0.32 | 9.56‡ ± 0.68 | 9.82 ± 1.24 | |
Superior surface area | 8.35 ± 1.96 | - | 8.85 ± 1.23 | 10.02 ± 2.35 | 9.89 ± 3.32 | - | 9.46 ± 0.76 | 10.09 ± 3.32 | |
Facet surface area | 1.31 ± 0.56 | 1.85† ± 0.38 | 1.93‡ ± 0.26 | 1.71 ± 0.51 | 1.29* ± 0.42 | 1.43† ± 0.23 | 1.53‡ ± 0.11 | 1.47 ± 0.46 |
Values are presented as mean±standard deviation.
Blank cells (-) denote variants that do not present a measurable anatomical feature on one side (incomplete fusions).
Variable | Type II/high | Type I/normal | Type III/low |
---|---|---|---|
Linear dimension (mm) | |||
Sacral height | 94.82* ± 7.81 | 105.05 ± 10.24 | 108.4 ± 14.72 |
Auricular surface height | 60.04 ± 6.36 | 61.15 ± 8.16 | 61.97 ± 5.01 |
Inter facet distance | 102.04 ± 6.3 | 102.79 ± 10.09 | 100.86 ± 10.25 |
Inter auricular distance | 42.9 ± 5.9 | 46.34 ± 6.62 | 46.97 ± 5.63 |
Alar width bilateral | 47.88 ± 5.07 | 52.12 ± 4.34 | 47.9 ± 6.1 |
S1 body width | 59.14 ± 3.4 | 56.45 ± 3.47 | 53.89 ± 4.62 |
Facet depth | 13.98 ± 2.7 | 15.24 ± 2.9 | 15.88 ± 3.62 |
Surface area (cm2) | |||
Auricular surface area | 10.98 ± 1.78 | 10.36 ± 1.86 | 10.06 ± 1.58 |
Superior surface area | 9.85 ± 2.3 | 10.02 ± 2.35 | 9.89 ± 2.82 |
Facet surface area | 1.52 ± 0.48 | 1.71 ± 0.51 | 1.77 ± 0.48 |
Transverse element obliquity & thickness | |||
S1 obliquity of the upper osseous corridor (°) | 16.64 ± 2.40 | 25.30 ± 3.79 | 30.6* ± 5.82 |
33.0* ± 4.33 | |||
S1 craniocaudal thickness (mm) | 21.90 ± 3.41 | 19.40 ± 4.88 | 21.10 ± 2.39 |
13.88* ± 3.45 | |||
S2 craniocaudal thickness (mm) | 14.56 ± 3.14 | 13.60 ± 2.45 | 15.64 ± 2.67 |
19.48* ± 3.40 |