{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:31:03Z","timestamp":1783035063607,"version":"3.54.6"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Oulu including Oulu University Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>To assess the prevalence of lumbosacral transitional vertebra (LSTV) and associated spinal degenerative changes on abdominal CT scans in Caucasian population.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Material and methods<\/jats:title>\n<jats:p>A total of 3855 abdominal CT scans of the year 2017 from a single hospital were retrospectively assessed for LSTV, disc degeneration (DD), and facet joint degeneration (FD). An age- and sex-matched 150-subject control group without LSTV was picked at random. Multivariable logistic regression was used for the analysis.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>LSTV was found in 1101 (29%) scans: Castellvi type I in 68%, type II in 16%, type III in 13%, and type IV in 3% of scans. Age- and sex-adjusted prevalence of DD was significantly higher in Castellvi type II and III groups at multiple lumbar levels, and in IV group at L4\/5 than in control group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001\u20130.034). At L5\/S1, the prevalence of DD was significantly higher in the control group than in type II, III, or IV groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001\u20130.017). After combining Castellvi types II, III, and IV into one group, significant differences were found at all lumbar levels except L2\/3 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001\u20130.016). Prevalence of FD was significantly higher at L4\/5 in Castellvi groups I, II, and III than in the control group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001\u20130.002). When Castellvi types II, III, and IV were combined into one group, significant differences were found at lumbar levels L2\/3, L3\/4, and L4\/5 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001\u20130.021).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Lumbosacral vertebrae of Castellvi types II, III, and IV are associated with greater lumbar degeneration, warranting meticulous evaluation of spinal anatomy, even on CT.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Key Points<\/jats:title>\n<jats:p><jats:italic>\u2022 Lumbosacral transitional vertebra is a common incidental finding on abdominal CT scans with a high prevalence of 29%.<\/jats:italic><\/jats:p>\n<jats:p><jats:italic>\u2022 When assessing whole lumbar spine, lumbosacral vertebrae of Castellvi types II, III, and IV were associated with greater lumbar degeneration, warranting careful evaluation of the lumbar spine on abdominal CT scans.<\/jats:italic><\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00330-020-06691-2","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T03:02:53Z","timestamp":1582081373000},"page":"3409-3416","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans"],"prefix":"10.1007","volume":"30","author":[{"given":"Jaakko","family":"Hanhivaara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani H.","family":"M\u00e4\u00e4tt\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaakko","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9483-7690","authenticated-orcid":false,"given":"Mika T.","family":"Nevalainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"6691_CR1","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.3174\/ajnr.A2036","volume":"31","author":"GP Konin","year":"2010","unstructured":"Konin GP, Walz DM (2010) Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR Am J Neuroradiol 31:1778\u20131786. https:\/\/doi.org\/10.3174\/ajnr.A2036","journal-title":"AJNR Am J Neuroradiol"},{"key":"6691_CR2","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1016\/j.crad.2004.02.019","volume":"59","author":"RJ Hughes","year":"2004","unstructured":"Hughes RJ, Saifuddin A (2004) Imaging of lumbosacral transitional vertebrae. Clin Radiol 59:984\u2013991","journal-title":"Clin Radiol"},{"key":"6691_CR3","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1097\/00007632-198407000-00014","volume":"9","author":"AE Castellvi","year":"1984","unstructured":"Castellvi AE, Goldstein LA, Chan DP (1984) Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine (Phila Pa 1976) 9:493\u2013495","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR4","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1007\/s00256-018-2900-1","volume":"47","author":"MT Nevalainen","year":"2018","unstructured":"Nevalainen MT, McCarthy E, Morrison WB, Zoga AC, Roedl JB (2018) Lumbosacral transitional vertebrae: significance of local bone marrow edema at the transverse processes. Skeletal Radiol 47:1145\u20131149. https:\/\/doi.org\/10.1007\/s00256-018-2900-1","journal-title":"Skeletal Radiol"},{"key":"6691_CR5","doi-asserted-by":"publisher","first-page":"E573","DOI":"10.1097\/BRS.0b013e31828b7195","volume":"38","author":"NC Paik","year":"2013","unstructured":"Paik NC, Lim CS, Jang HS (2013) Numeric and morphological verification of lumbosacral segments in 8280 consecutive patients. Spine (Phila Pa 1976) 38:E573\u2013E578. https:\/\/doi.org\/10.1097\/BRS.0b013e31828b7195","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR6","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1016\/j.spinee.2011.08.005","volume":"11","author":"A Apazidis","year":"2011","unstructured":"Apazidis A, Ricart PA, Diefenbach CM, Spivak JM (2011) The prevalence of transitional vertebrae in the lumbar spine. Spine J 11:858\u2013862. https:\/\/doi.org\/10.1016\/j.spinee.2011.08.005","journal-title":"Spine J"},{"key":"6691_CR7","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1055\/s-0034-1387808","volume":"4","author":"HD French","year":"2014","unstructured":"French HD, Somasundaram AJ, Schaefer NR, Laherty RW (2014) Lumbosacral transitional vertebrae and its prevalence in the australian population. Global Spine J 4:229\u2013232. https:\/\/doi.org\/10.1055\/s-0034-1387808","journal-title":"Global Spine J"},{"key":"6691_CR8","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1016\/j.ejrad.2014.05.036","volume":"83","author":"M Tang","year":"2014","unstructured":"Tang M, Yang XF, Yang SW et al (2014) Lumbosacral transitional vertebra in a population-based study of 5860 individuals: prevalence and relationship to low back pain. Eur J Radiol 83:1679\u20131682. https:\/\/doi.org\/10.1016\/j.ejrad.2014.05.036","journal-title":"Eur J Radiol"},{"key":"6691_CR9","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1051\/sicotj\/2017055","volume":"3","author":"EK Holm","year":"2017","unstructured":"Holm EK, Bunger C, Foldager CB (2017) Symptomatic lumbosacral transitional vertebra: a review of the current literature and clinical outcomes following steroid injection or surgical intervention. SICOT J 3:71. https:\/\/doi.org\/10.1051\/sicotj\/2017055","journal-title":"SICOT J"},{"key":"6691_CR10","doi-asserted-by":"publisher","first-page":"42","DOI":"10.14444\/2042","volume":"9","author":"JM Jancuska","year":"2015","unstructured":"Jancuska JM, Spivak JM, Bendo JA (2015) A review of symptomatic lumbosacral transitional vertebrae: Bertolotti\u2019s syndrome. Int J Spine Surg 9:42. https:\/\/doi.org\/10.14444\/2042","journal-title":"Int J Spine Surg"},{"key":"6691_CR11","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s11547-018-0974-4","volume":"124","author":"M Apaydin","year":"2019","unstructured":"Apaydin M, Uluc ME, Sezgin G (2019) Lumbosacral transitional vertebra in the young men population with low back pain: anatomical considerations and degenerations (transitional vertebra types in the young men population with low back pain). Radiol Med 124:375\u2013381. https:\/\/doi.org\/10.1007\/s11547-018-0974-4","journal-title":"Radiol Med"},{"key":"6691_CR12","unstructured":"Bertolotti M (1917) Contributo alla conoscenza dei vizi di differenziazione regionale del rachide con speciale riguardo all assimilazione sacrale della v. lombare. Radiol Med (Torino) 4:113\u2013144"},{"key":"6691_CR13","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1093\/rheumatology\/16.3.180","volume":"16","author":"PG Tini","year":"1977","unstructured":"Tini PG, Wieser C, Zinn WM (1977) The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance. Rheumatol Rehabil 16:180\u2013185","journal-title":"Rheumatol Rehabil"},{"key":"6691_CR14","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1097\/01.BRS.0000107223.02346.A8","volume":"29","author":"K Luoma","year":"2004","unstructured":"Luoma K, Vehmas T, Raininko R, Luukkonen R, Riihimaki H (2004) Lumbosacral transitional vertebra: relation to disc degeneration and low back pain. Spine (Phila Pa 1976) 29:200\u2013205. https:\/\/doi.org\/10.1097\/01.BRS.0000107223.02346.A8","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR15","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1620\/tjem.242.223","volume":"242","author":"T Nakagawa","year":"2017","unstructured":"Nakagawa T, Hashimoto K, Tsubakino T, Hoshikawa T, Inawashiro T, Tanaka Y (2017) Lumbosacral transitional vertebrae cause spinal level misconception in surgeries for degenerative lumbar spine disorders. Tohoku J Exp Med 242:223\u2013228. https:\/\/doi.org\/10.1620\/tjem.242.223","journal-title":"Tohoku J Exp Med"},{"key":"6691_CR16","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1302\/0301-620X.88B9.17211","volume":"88","author":"JF Quinlan","year":"2006","unstructured":"Quinlan JF, Duke D, Eustace S (2006) Bertolotti\u2019s syndrome. A cause of back pain in young people. J Bone Joint Surg Br 88:1183\u20131186","journal-title":"J Bone Joint Surg Br"},{"key":"6691_CR17","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1148\/radiol.12112747","volume":"265","author":"L Nardo","year":"2012","unstructured":"Nardo L, Alizai H, Virayavanich W et al (2012) Lumbosacral transitional vertebrae: association with low back pain. Radiology 265:497\u2013503. https:\/\/doi.org\/10.1148\/radiol.12112747","journal-title":"Radiology"},{"key":"6691_CR18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1007\/bf01301431","volume":"6","author":"S Vergauwen","year":"1997","unstructured":"Vergauwen S, Parizel PM, van Breusegem L et al (1997) Distribution and incidence of degenerative spine changes in patients with a lumbo-sacral transitional vertebra. Eur Spine J 6:168\u2013172. https:\/\/doi.org\/10.1007\/bf01301431","journal-title":"Eur Spine J"},{"key":"6691_CR19","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1097\/00007632-198912000-00015","volume":"14","author":"AD Elster","year":"1989","unstructured":"Elster AD (1989) Bertolotti\u2019s syndrome revisited. Transitional vertebrae of the lumbar spine. Spine (Phila Pa 1976) 14:1373\u20131377","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR20","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1016\/j.spinee.2013.10.029","volume":"15","author":"NA Farshad-Amacker","year":"2015","unstructured":"Farshad-Amacker NA, Herzog RJ, Hughes AP, Aichmair A, Farshad M (2015) Associations between lumbosacral transitional anatomy types and degeneration at the transitional and adjacent segments. Spine J 15:1210\u20131216. https:\/\/doi.org\/10.1016\/j.spinee.2013.10.029","journal-title":"Spine J"},{"key":"6691_CR21","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1007\/s00586-005-0954-y","volume":"15","author":"A Kettler","year":"2006","unstructured":"Kettler A, Wilke HJ (2006) Review of existing grading systems for cervical or lumbar disc and facet joint degeneration. Eur Spine J 15:705\u2013718. https:\/\/doi.org\/10.1007\/s00586-005-0954-y","journal-title":"Eur Spine J"},{"key":"6691_CR22","first-page":"1911","volume":"20","author":"NE Lane","year":"1993","unstructured":"Lane NE, Nevitt MC, Genant HK, Hochberg MC (1993) Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration. J Rheumatol 20:1911\u20131918","journal-title":"J Rheumatol"},{"key":"6691_CR23","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s002560050503","volume":"28","author":"D Weishaupt","year":"1999","unstructured":"Weishaupt D, Zanetti M, Boos N, Hodler J (1999) MR imaging and CT in osteoarthritis of the lumbar facet joints. Skeletal Radiol 28:215\u2013219. https:\/\/doi.org\/10.1007\/s002560050503","journal-title":"Skeletal Radiol"},{"key":"6691_CR24","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1007\/s005860000239","volume":"10","author":"MN Kumar","year":"2001","unstructured":"Kumar MN, Baklanov A, Chopin D (2001) Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 10:314\u2013319. https:\/\/doi.org\/10.1007\/s005860000239","journal-title":"Eur Spine J"},{"key":"6691_CR25","doi-asserted-by":"publisher","first-page":"205","DOI":"10.4184\/asj.2016.10.2.205","volume":"10","author":"GR Srinivas","year":"2016","unstructured":"Srinivas GR, Deb A, Kumar MN, Kurnool G (2016) Long-term effects of segmental lumbar spinal fusion on adjacent healthy discs: a finite element study. Asian Spine J 10:205\u2013214. https:\/\/doi.org\/10.4184\/asj.2016.10.2.205","journal-title":"Asian Spine J"},{"key":"6691_CR26","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/00007632-198404000-00013","volume":"9","author":"M Pearcy","year":"1984","unstructured":"Pearcy M, Portek I, Shepherd J (1984) Three-dimensional X-ray analysis of normal movement in the lumbar spine. Spine (Phila Pa 1976) 9:294\u2013297","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR27","doi-asserted-by":"publisher","first-page":"371","DOI":"10.3171\/2011.6.SPINE11113","volume":"15","author":"NK Mahato","year":"2011","unstructured":"Mahato NK (2011) Disc spaces, vertebral dimensions, and angle values at the lumbar region: a radioanatomical perspective in spines with L5-S1 transitions: clinical article. J Neurosurg Spine 15:371\u2013379. https:\/\/doi.org\/10.3171\/2011.6.SPINE11113","journal-title":"J Neurosurg Spine"},{"key":"6691_CR28","doi-asserted-by":"publisher","first-page":"E1187","DOI":"10.1097\/BRS.0b013e318206bdf7","volume":"36","author":"NK Mahato","year":"2011","unstructured":"Mahato NK (2011) Pedicular anatomy of the first sacral segment in transitional variations of the lumbo-sacral junction. Spine (Phila Pa 1976) 36:E1187\u2013E1192. https:\/\/doi.org\/10.1097\/BRS.0b013e318206bdf7","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR29","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1302\/0301-620X.87B5.15727","volume":"87","author":"T Aihara","year":"2005","unstructured":"Aihara T, Takahashi K, Ogasawara A, Itadera E, Ono Y, Moriya H (2005) Intervertebral disc degeneration associated with lumbosacral transitional vertebrae: a clinical and anatomical study. J Bone Joint Surg Br 87:687\u2013691","journal-title":"J Bone Joint Surg Br"},{"key":"6691_CR30","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1097\/00007632-198906000-00013","volume":"14","author":"DH Chow","year":"1989","unstructured":"Chow DH, Luk KD, Leong JC, Woo CW (1989) Torsional stability of the lumbosacral junction. Significance of the iliolumbar ligament. Spine (Phila Pa 1976) 14:611\u2013615","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR31","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1097\/00007632-200005010-00010","volume":"25","author":"JM Hartford","year":"2000","unstructured":"Hartford JM, McCullen GM, Harris R, Brown CC (2000) The iliolumbar ligament: three-dimensional volume imaging and computer reformatting by magnetic resonance: a technical note. Spine (Phila Pa 1976) 25:1098\u20131103","journal-title":"Spine (Phila Pa 1976)"},{"key":"6691_CR32","doi-asserted-by":"publisher","first-page":"2394","DOI":"10.3174\/ajnr.A4498","volume":"36","author":"W Brinjikji","year":"2015","unstructured":"Brinjikji W, Diehn FE, Jarvik JG et al (2015) MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. AJNR Am J Neuroradiol 36:2394\u20132399. https:\/\/doi.org\/10.3174\/ajnr.A4498","journal-title":"AJNR Am J Neuroradiol"},{"key":"6691_CR33","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s00586-018-5554-8","volume":"27","author":"J Lian","year":"2018","unstructured":"Lian J, Levine N, Cho W (2018) A review of lumbosacral transitional vertebrae and associated vertebral numeration. Eur Spine J 27:995\u20131004. https:\/\/doi.org\/10.1007\/s00586-018-5554-8","journal-title":"Eur Spine J"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-06691-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00330-020-06691-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-06691-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T07:15:50Z","timestamp":1613718950000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00330-020-06691-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,19]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["6691"],"URL":"https:\/\/doi.org\/10.1007\/s00330-020-06691-2","relation":{},"ISSN":["0938-7994","1432-1084"],"issn-type":[{"value":"0938-7994","type":"print"},{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,19]]},"assertion":[{"value":"17 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Mika Nevalainen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors (Juhani M\u00e4\u00e4tt\u00e4) has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 Retrospective\u2022 Case-control study\u2022 Performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}