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.
Key words
Lumbosacral transitional vertebra /
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Adolescent /
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X-ray
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