目的 明确青少年群体中腰骶移行椎(LSTV )的发生率，并探究其与椎间隙狭窄、脊柱隐裂等腰骶部疾病的相关性。 方法 回顾性选取2024年1月1日至2025年4月28日之间于南方医科大学第三附属医院接受腰椎X线正位片拍摄的1至24岁青少年患者535例（男性278例，女性257例）。测量患者双侧L5横突宽度、依据Castellvi分型标准对LSTV进行分类，并分析这些参数与性别、年龄、腰骶部合并症的相关性。 结果 青少年LSTV发生率为47.10%，在不同性别之间无差异。L5横突宽度与年龄存在正相关（r=0.537, P<0.001）。横突增厚组平均年龄大于正常组（P<0.001），大于假关节组（P=0.024）、大于融合组（P=0.001）；假关节组平均年龄大于正常组（P=0.045）。单纯肥大组的椎间隙狭窄患病率显著高于正常组（P=0.013）；显著高于假关节+融合组（P=0.018）。异常组的L5/S1椎间隙狭窄患病率显著高于正常组（P=0.046）；假关节+融合组的L5/S1椎间隙狭窄患病率显著高于正常组（P=0.044），其余各组之间均无显著差异。 结论 本研究通过观察腰部 X 线正位片得出青少年群体中LSTV的发生率较高，且存在LSTV的青少年更易出现椎间隙狭窄，明确青少年LSTV的临床特点有助于对其进行风险评估，并进一步指导疾病的诊断与治疗。
Abstract
Objective To determine the prevalence of lumbosacral transitional vertebra (LSTV) in adolescents and investigate its association with lumbosacral pathologies, including intervertebral space stenosis and spina bifida occulta. Methods A retrospective study was conducted on 535 adolescent patients (278 males, 257 females; aged 1-24 years) who underwent lumbar anteroposterior radiography at the Third Affiliated Hospital of Southern Medical University between January 1, 2024 and April 28, 2025. Bilateral L5 transverse process widths were measured, LSTV was classified according to the Castellvi classification system, and correlations between these parameters and sex, age, and lumbosacral comorbidities were analyzed. Results The overall prevalence of LSTV in adolescents was 47.10%, with no significant sex-based differences. L5 transverse process width exhibited a significant positive correlation with age (r=0.537, P<0.001). The transverse process hypertrophy group had a significantly higher mean age than the normal group (P<0.001), pseudoarthrosis group (P=0.024), and fusion group (P=0.001). The pseudoarthrosis group showed a significantly higher mean age compared to the normal group (P=0.045). The hypertrophy group had a significantly higher prevalence of intervertebral space stenosis than the normal group (P=0.013) and the pseudoarthrosis + fusion group (P=0.018). The LSTV-positive group exhibited a higher prevalence of L5/S1 intervertebral space stenosis compared to the normal group (P=0.046), with similar findings in the pseudoarthrosis + fusion subgroup (P=0.044). Conclusions This study highlights a high prevalence of LSTV in adolescents, with significant associations between LSTV and intervertebral space stenosis. These findings underscore the importance of radiographic screening for LSTV in adolescents with lumbosacral symptoms, providing insights for risk stratification and personalized treatment strategies.
关键词
腰骶移行椎 /
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青少年 /
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X线
Key words
Lumbosacral transitional vertebra /
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Adolescent /
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X-ray
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基金
国家自然科学基金（82274669）；广东省名中医传承工作室建设项目（粤中医办函[2023]108号）；深圳市“医疗卫生三名工程”项目资助（SZZYSM202108013）
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