What is a lumbosacral transitional vertebra

In the normal spine, the 24th vertebra below the occiput is the last presacral vertebra (L5), and the 25th vertebral segment is the body of S1. In the normal spine, there are five non-rib-bearing lumbar vertebra above the sacrum. People who possess four non-rib-bearing lumbar vertebra are considered to have sacralization of the L5 vertebra. People who possess six non-rib-bearing lumbar vertebra are considered to have lumbarization of the S1 vertebral body. The term lumbosacral transitional vertebra has been adopted because it is difficult to determine whether the transitional vertebra is the 24th or 25th vertebra below the occiput without obtaining additional spinal radiographs. There are a variety of types of lumbosacral transitional vertebra. Vertebral anomalies ranging from hyperplasia of the transverse processes to large transverse processes that articulate with the sacrum or fusion of the transverse process and vertebral body with the sacrum may occur. These abnormalities may be partial or complete, unilateral or bilateral. Proper identification of lumbar spine segments in relation to the sacrum on plain radiographs is essential in planning lumbar spine procedures to ensure that surgery is carried out at the correct spinal level(s).

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