PREVALENCE AND RADIOGRAPHY PATTERNS OF LUMBOSACRAL TRANSITIONAL VERTEBRA AMONGST PATIENTS AT MULAGO NATIONAL REFERRAL HOSPITAL

Abstract

Background: LSTV is known to be associated with low back pain. In Uganda, there is paucity of documented data on prevalence of lumbosacral transitional vertebra (LSTV) among patients referred for lumbosacral spine radiographic examination. This is despite the high burden of low back pain as a major complaint affecting about 7 of every 10 patients presenting at the orthopaedic clinics. Further more accurate identification of the same by the radiologists is important as this helps in correct level intervention in LSTV symptomatic patients. Objectives: The study aimed to determine the prevalence of LSTV and also describe the plain radiographic patterns and types of LSTV among patients seeking lumbar- sacral spine X-ray services in Mulago National Referral Hospital (MNRH), Uganda. Methods: This was a cross sectional study that was carried out at MNRH, in the radiology department from 27th February 2018- 31st March 2018. Adults (≥18years) who presented for lumbosacral X-ray examination were enrolled into the study. Data from169 participants was collected using a standardized questionnaire. The questionnaire included socio-demographic characteristics, clinical characteristics and the radiographic features classified by Castellvi classification. Results: The Prevalence of LSTV was 10.1%. The first three age groups were more affected (18-29 years, 30-44 years and 45-59 years). Castellvi Type 1 accounted for (35.2%), Castellvi Type II (35.2 %), Type III (23.5%) and Type IV (5.9%). Sacralisation was more common than lumbarisation (82% vs. 18%).There was no association between LSTV, low back pain and a positive family history. However among those with LSTV, the odds of having either characteristic was 1.2 and 2.44 times respectively. Conclusion: LSTV is a common condition found in Mulago Hospital with Castellvi types I and II being the commonest anatomical variants and sacralisation being commoner than lumbarisation. Among those with LSTV, back pain and positive family history showed no correlation though the odds of having both was greatly increased.