Association Between Lumbosacral Transitional Vertebrae and Spondylolisthesis: A Systematic Review and Meta-Analysis.
Stylianos Kapetanakis, Mikail Chatzivasiliadis, Christodoulos Kizis
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In 30 seconds
This systematic review and meta-analysis examined whether lumbosacral transitional vertebrae (LSTV) are associated with the prevalence, level, and severity of degenerative spondylolisthesis in adults. It pooled 12 retrospective cohort studies involving 3,929 participants. LSTV was not associated with a statistically significant increase in overall prevalence (OR 1.28; 95% CI 0.86-1.91; p = 0.22), but was associated with markedly different anatomical distribution: higher odds at L4-L5 and lower odds at L5-S1. Pooled analyses found no significant difference in slip severity.
Key findings
- Overall degenerative spondylolisthesis prevalence did not differ significantly with LSTV (OR 1.28; 95% CI 0.86-1.91; p = 0.22).
- LSTV was associated with higher odds of spondylolisthesis at L4-L5 (OR 13.78; 95% CI 4.30-44.18; p < 0.0001).
- At L5-S1, LSTV was associated with lower odds of spondylolisthesis (OR 0.07; 95% CI 0.02-0.23; p < 0.0001).
- Pooled analyses found no significant difference in slip severity (p = 0.31).
Why it matters
The findings distinguish overall disease prevalence from its anatomical distribution. Although LSTV was not linked to greater overall prevalence, the marked shift in observed slippage toward L4-L5 may be relevant when interpreting imaging and considering the level of degenerative pathology. The evidence describes an association and does not establish that LSTV causes this redistribution.
What to keep in mind
The evidence came from 12 retrospective cohort studies, so the findings are observational and cannot establish causation.