Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct;54(10):2169-2177.
doi: 10.1007/s00256-025-04952-z. Epub 2025 May 17.

Lumbosacral transitional vertebra on whole-spine CT: prevalence and association with rib abnormalities

Shuji Nagata  1 , Chihiro Yamada  2 , Miyuki Sawano  3 , Yuki Shouji  3 , Gaku Shioyama  3 , Shinobu Nakamura  4 , Yusuke Uchiyama  3 , Hiroshi Nishimura  5 , Shuichi Tanoue  3
Affiliations

Lumbosacral transitional vertebra on whole-spine CT: prevalence and association with rib abnormalities

Shuji Nagata et al. Skeletal Radiol. 2025 Oct.

Abstract

Objective: To determine the prevalence of lumbosacral transitional vertebrae (LSTV) and rib abnormalities and investigate the association between LSTV subtypes and rib abnormalities using whole-spine CT.

Materials and methods: The vertebral levels were counted caudally from the cervical vertebra, based on the eighth being the first thoracic vertebra, the twentieth as the first lumbar vertebra, and the twenty-fifth being the first sacral vertebra using sagittal reconstructed CT. Sacralization is when 23 vertebrae are found, whereas lumbarization is the presence of 25 vertebrae.

Results: This retrospective study included 551 patients (407 females and 144 males). There is no evidence of a difference in age and sex that was observed between the LSTV and no LSTV groups (95% CIs; - 0.34, 3.08; p = 0.12 and p = 0.24, respectively). LSTV were reported in 16.3% of participants, consisting of 12.3% of sacralization and 4.0% of lumbarization. The incidence rate of lumbarization was significantly high in male participants (p = 0.031). Rib abnormalities were reported in 14.0% of participants, consisting of 12.6% of twelfth hypoplastic rib and 1.5% of lumbar rib. In patients with LSTV, all twelfth hypoplastic ribs were found in the sacralization group and all lumbar ribs were found in the lumbarization group (p < 0.001). The types based on the Castellvi classification demonstrated a significant difference between the sacralization and lumbarization groups (p = 0.007).

Conclusion: The findings of our study suggest that patients with sacralization and lumbarization are predisposed to having twelfth hypoplastic ribs and lumbar ribs, respectively.

Keywords: Castellvi classification; Lumbarization; Lumbosacral transitional vertebrae; Sacralization; Whole-spine CT.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethics Committee of Kurume University (approval no.24119) which waived the requirement for informed consent. Conflict of interest: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Konin GP, Walz DM. Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR Am J Neuroradiol. 2010;31(10):1778–86. - PubMed - PMC
    1. Apazidis A, Ricart PA, Diefenbach CM, Spivak JM. The prevalence of transitional vertebrae in the lumbar spine. Spine J. 2011;11(9):858–62. - PubMed
    1. Tang M, Yang XF, Yang SW, Han P, Ma YM, Yu H, et al. Lumbosacral transitional vertebra in a population-based study of 5860 individuals: prevalence and relationship to low back pain. Eur J Radiol. 2014;83(9):1679–82. - PubMed
    1. Tins BJ, Balain B. Incidence of numerical variants and transitional lumbosacral vertebrae on whole-spine MRI. Insights Imaging. 2016;7(2):199–203. - PubMed - PMC
    1. Nakajima A, Usui A, Hosokai Y, Kawasumi Y, Abiko K, Funayama M, et al. The prevalence of morphological changes in the thoracolumbar spine on whole-spine computed tomographic images. Insights Imaging. 2014;5(1):77–83. - PubMed