SynthesisPain practice : the official journal of World Institute of Pain2026
Radiologic Insights: Diagnosing Lumbosacral Transitional Vertebrae. Systematic Review of the Literature.
Synthesis in Pain practice : the official journal of World Institute of Pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Sacroiliac Joint Anatomical Variants and Their Association with Spinopelvic Alignment: A Whole-Spine CT Study.Tomography (Ann Arbor, Mich.) · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe lumbosacral transitional vertebra (LSTV) has been studied since 1876, with Castellvi developing a classification in 1984 based on its anatomy and laterality. It often goes unnoticed, or its diagnosis is limited to a lumbar spine X-ray for confirmation. This has led to LSTV being underdiagnosed or even ignored. Our aim is to describe and evaluate radiological diagnostic techniques for LSTV and propose a diagnostic methodology to reduce errors in vertebral level identification, useful for percutaneous procedures and/or biomechanical measurement analysis. MATERIALS AND
methodsA systematic literature review was conducted. The search terms included: "Castellvi," "Lumbosacral Transitional Vertebra," "Radiology." Logical connectors such as "and" and "or" were applied. The following databases were reviewed: Scopus, PubMed, Ovid, ScienceDirect, EBSCO, and Nature. The timeframe was limited from 2004 to December 2024. Inclusion and exclusion criteria were applied. A total of 419 articles were identified. The "Rayyan" program was used to compile information, and "PRISMA," "STROBE," and "CONSORT" were used to facilitate the analysis process.
resultsForty-eight articles were included and analyzed (10 CT, 4 PET-CT, 2 bone scans, 9 MRI, 6 X-rays, 4 EOS, and 13 mixed). The most common findings highlighted CT as the gold standard for diagnosing LSTV, with spinopelvic parameters correlating with LSTV. Radiography is effective for vertebral numbering. MRI studies utilize anatomical landmarks to identify vertebral levels and LSTV, although they are less sensitive. EOS is also used for vertebral level identification.
conclusionsOur proposed diagnostic methodology for LSTV includes: first, using plain AP radiography for cranial-to-caudal vertebral numbering and evaluating morphological anomalies. Second, if LSTV is suspected, performing CT as the gold standard for diagnosis due to its high sensitivity and specificity, and measuring spinopelvic parameters to correlate with LSTV. Third, using MRI in special cases. Fourth, conducting a morphological analysis and using Jenkins' classification for LSTV categorization.
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