E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Effect of lumbosacral transitional vertebra on bone quality in the lumbar spine: A retrospective quantitative study
Tüzün Harun Yasin✉ ,
Yüzügüldü Uğur ,
Yıldırım Eda ,
Keleş Enes ,
Bozlar Uğur ,
Taşar Mustafa ,
Erşen Ömer
Orthopedics, Gülhane Education and Research Hospital
DOI: 10.5137/1019-5149.JTN.50981-26.2
Accepted: 24/05/2026
Article in Press
Corresponding Author:
Tüzün Harun Yasin (tuzundr@yahoo.com)
Abstract
Aim
To compare Hounsfield unit (HU) measurements of lumbar vertebrae between patients with lumbosacral transitional vertebrae (LSTV) and age- and sex-matched controls without LSTV using abdominal computed tomography (CT) images.
Material and Methods
This quantitative retrospective study reviewed all abdominal CT scans performed at our hospital between July 2024 and June 2025. Data were recorded for all patients with LSTV and for age- and sex-matched controls without LSTV. Two experienced physicians independently performed HU measurements, and the average was used in the analyses. After performing HU measurements at all vertebral levels, the ratio of the L5 and S1 measurements to the average of the L1–4 measurements was calculated.
Results
A total of 344 patients with LSTVs (142 females and 202 males) were identified. Compared to the non-LSTV group, HU measurements were significantly lower in the LSTV group, except for L5, whereas the ratio of the L5 measurement to the L1–4 average was higher in the LSTV group. Among LSTV types, type 3 LSTVs had significantly higher HU measurements at L5 (p = 0.008). Compared to type 1 and 2 LSTVs, type 3 and 4 LSTVs had significantly higher HU measurements at L5 (p = 0.039) and lower HU measurements at S1 (p = 0.018).
Conclusion
The findings demonstrate that LSTV decreases bone quality in the lumbar spine, where the load distribution due to LSTV increases bone quality at the L5 level. In addition, LSTV types with transverse processes fused to the sacrum had bone quality changes at the L5 and S1 levels.
To compare Hounsfield unit (HU) measurements of lumbar vertebrae between patients with lumbosacral transitional vertebrae (LSTV) and age- and sex-matched controls without LSTV using abdominal computed tomography (CT) images.
Material and Methods
This quantitative retrospective study reviewed all abdominal CT scans performed at our hospital between July 2024 and June 2025. Data were recorded for all patients with LSTV and for age- and sex-matched controls without LSTV. Two experienced physicians independently performed HU measurements, and the average was used in the analyses. After performing HU measurements at all vertebral levels, the ratio of the L5 and S1 measurements to the average of the L1–4 measurements was calculated.
Results
A total of 344 patients with LSTVs (142 females and 202 males) were identified. Compared to the non-LSTV group, HU measurements were significantly lower in the LSTV group, except for L5, whereas the ratio of the L5 measurement to the L1–4 average was higher in the LSTV group. Among LSTV types, type 3 LSTVs had significantly higher HU measurements at L5 (p = 0.008). Compared to type 1 and 2 LSTVs, type 3 and 4 LSTVs had significantly higher HU measurements at L5 (p = 0.039) and lower HU measurements at S1 (p = 0.018).
Conclusion
The findings demonstrate that LSTV decreases bone quality in the lumbar spine, where the load distribution due to LSTV increases bone quality at the L5 level. In addition, LSTV types with transverse processes fused to the sacrum had bone quality changes at the L5 and S1 levels.
Keywords
Lumbosacral transitional vertebra
Bone quality
HU value
Tomography
Spine