Lumbosacral transitional vertebrae and its prevalence in the Australian population.
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ABSTRACT:
SUBMITTER: French HD
PROVIDER: S-EPMC4229381 | biostudies-other | 2014 Dec
REPOSITORIES: biostudies-other
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Project description:To assess the prevalence and degree of lumbosacral transitional vertebrae (LSTV) in the Osteoarthritis Initiative (OAI) cohort, to assess whether LSTV correlates with low back pain (LBP) and buttock pain, and to assess the reproducibility of grading LSTV.Institutional review board approval was obtained, and informed consent documentation was approved for the study protocol. Standard standing pelvic radiographs that included the transverse processes of L5 were graded according to Castellvi classification of LSTV in 4636 participants (1992 men and 2804 women; aged 45-80 years) from the OAI cohort. These data were correlated with prevalence and severity of LBP and buttock pain.Prevalence of LSTV was 18.1% (841 of 4636), with a higher rate in men than in women (28.1% vs 11.1%, respectively; P<.001). Of the 841 individuals with LSTV, 41.72% were type I (dysplastic enlarged transverse process), 41.4% were type II (pseudoarticulation), 11.5% were type III (fusion), and 5.2% were type IV (one transverse process fused and one with pseudoarticulation). Of the participants without LSTV, 53.9% reported LBP, while the prevalence of LBP for types I, II, III, and IV was 46%, 73%, 40%, and 66%, respectively (P<.05, χ2 test). Types II and IV had higher prevalence and severity of LBP and buttock pain (P<.001).LSTV types II and IV positively correlate with prevalence and severity of LBP and buttock pain.
| S-EPMC3480814 | biostudies-other
Project description:To investigated the rate of occurrence of lumbosacral transitional vertebrae (LSTV), spinal variant, in kidney urinary bladder (KUB) plain radiographs in a Saudi population. Methods: Between January 2012 to January 2015, KUB plain films obtained from patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, were reviewed, and the presence or absence of LSTV was documented and classified as incomplete or complete. Patients who had evidence of spinal surgery that would obscure the view were excluded. Results: A total of 2078 patients underwent KUB examinations during the study period; LSTV anomalies were detected in 158 of these. Sacralization was present in 153 (96.8%) of this cohort, while lumbarization was present in 5 (3.2%). A total of 136 (86.1%) of the sacralized segments were of the incomplete type, whereas 17 (10.7%) were complete. Of the lumbarized vertebrae, 3 (1.8%) were incomplete, and 2 (1.2%) were complete. The most frequent type in men was type Ib (28.5%) for sacralized segments, and type IIb for lumbarized segments (0.6%). In women, type Ia was the most common form of sacralized segments (11.3%) and type IIb was the most common form of lumbarized segments (2.8%). Conclusion: The prevalence of LSTV in Saudi patients is 7.6%, with a higher incidence of sacralization than lumbarization. Further studies with larger sample sizes and longer follow-up time are needed to demonstrate the clinical significance thereof.
| S-EPMC5556294 | biostudies-other
Project description:OBJECTIVES:To assess the prevalence of lumbosacral transitional vertebra (LSTV) and associated spinal degenerative changes on abdominal CT scans in Caucasian population. MATERIAL AND METHODS:A total of 3855 abdominal CT scans of the year 2017 from a single hospital were retrospectively assessed for LSTV, disc degeneration (DD), and facet joint degeneration (FD). An age- and sex-matched 150-subject control group without LSTV was picked at random. Multivariable logistic regression was used for the analysis. RESULTS:LSTV was found in 1101 (29%) scans: Castellvi type I in 68%, type II in 16%, type III in 13%, and type IV in 3% of scans. Age- and sex-adjusted prevalence of DD was significantly higher in Castellvi type II and III groups at multiple lumbar levels, and in IV group at L4/5 than in control group (p?<?0.001-0.034). At L5/S1, the prevalence of DD was significantly higher in the control group than in type II, III, or IV groups (p?<?0.001-0.017). After combining Castellvi types II, III, and IV into one group, significant differences were found at all lumbar levels except L2/3 (p?<?0.001-0.016). Prevalence of FD was significantly higher at L4/5 in Castellvi groups I, II, and III than in the control group (p?<?0.001-0.002). When Castellvi types II, III, and IV were combined into one group, significant differences were found at lumbar levels L2/3, L3/4, and L4/5 (p?<?0.001-0.021). CONCLUSION:Lumbosacral vertebrae of Castellvi types II, III, and IV are associated with greater lumbar degeneration, warranting meticulous evaluation of spinal anatomy, even on CT. KEY POINTS:• Lumbosacral transitional vertebra is a common incidental finding on abdominal CT scans with a high prevalence of 29%. • When assessing whole lumbar spine, lumbosacral vertebrae of Castellvi types II, III, and IV were associated with greater lumbar degeneration, warranting careful evaluation of the lumbar spine on abdominal CT scans.
| S-EPMC7248049 | biostudies-literature
Project description:BackgroundThe variation at the lumbosacral junction certainly results in occult alignment changes in the lumbo-pelvic complexity (LPC). This retrospective case-control study aims to investigate the influences of lumbosacral transitional vertebrae (LSTV) on sagittal lumbo-pelvic balance assessment and provide some recommendations for preoperative imaging evaluation.MethodsBased on whole-body computed tomography (CT) images, a total of 210 individuals with complete segmentation anomalies of LSTV were included and divided into 23 presacral vertebrae (PSV) (sacralization, n=102), 25 PSV (lumbarization, n=108). The control group with 24 PSV (normal, n=100) was matched by age and gender. Sagittal lumbo-pelvic parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), sacral table angle (STA), sacral kyphosis (SK), and pelvic radius (PR) were measured at the ontogenetical S1 (Ontog S1) level and the morphological S1 (Morph S1), respectively. These parameters were compared using t-test, Kruskal-Wallis H test and post hoc test. Spearman's rank correlation coefficient and linear regression were used to investigate the association of lumbo-pelvic parameters with LSTV types and measurement levels.ResultsAll the parameters at the Ontog S1 differed significantly from those at the Morph S1 (all P<0.001). At the Ontog S1 level, PI, PT, SS, and LL were negatively correlated with vertebrae counts; SK and PR were positively correlated with vertebrae counts (all P<0.001). Instead, reverse results were obtained at the Morph S1 level. The measurement level and vertebrae counts were independent influence factors for the measurement of PI, PT, SS, SK, and PR (all P<0.05). Compared with the measured values of the matched controls, the variability of most lumbo-pelvic parameters (PI, SS, LL, STA, SK, PR values of 25 PSV subgroup, and PI, PT, SS, LL, STA values of 23 PSV subgroup) at the Morph S1 level were significantly smaller than that at the Ontog S1. The measurements of PT, SS, LL, and PR were less influenced by the measurement level and vertebrae counts than those of PI and SK.ConclusionsMorph S1 is more recommended for the measurements of most lumbo-pelvic parameters in patients with LSTV. The parameters (PT, SS, LL, STA, PR) are shown more stable and recommended to help reduce the effects caused by LSTV.
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Project description:BackgroundFor almost two decades, chlamydia and gonorrhoea diagnosis rates in remote Indigenous communities have been up to 30 times higher than for non-Indigenous Australians. The high levels of population movement known to occur between remote communities may contribute to these high rates.MethodsWe developed an individual-based computer simulation model to study the relationship between population movement and the persistence of gonorrhoea and chlamydia transmission within hypothetical remote communities.ResultsResults from our model suggest that short-term population movement can facilitate gonorrhoea and chlamydia persistence in small populations. By fixing the number of short-term travellers in accordance with census data, we found that these STIs can persist if at least 20% of individuals in the population seek additional partners while away from home and if the time away from home is less than 21 days. Periodic variations in travel patterns can contribute to increased sustainable levels of infection. Expanding existing STI testing and treatment programs to cater for short-term travellers is shown to be ineffective due to their short duration of stay. Testing and treatment strategies tailored to movement patterns, such as encouraging travellers to seek testing and treatment upon return from travel, will likely be more effective.ConclusionHigh population mobility is likely to contribute to the high levels of STIs observed in remote Indigenous communities of Australia. More detailed data on mobility patterns and sexual behaviour of travellers will be invaluable for designing and assessing STI control programs in highly mobile communities.
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Project description:Current dietary supplement use in Australia is not well described. We investigated the prevalence and predictors of supplement use in the Australian population (n = 19,257) using data from the 2014-2015 National Health Survey. We reported the prevalence of supplement use by sex and age group and investigated the independent predictors of supplement use in adults, adolescents, and children using multiple logistic regression models. A total of 43.2% of adults (34.9% of males, 50.3% of females), 20.1% of adolescents (19.7% of males, 20.6% of females), and 23.5% of children (24.4% of males, 22.5% of females) used at least one dietary supplement in the previous two weeks. The most commonly used supplements were multivitamins and/or multiminerals and fish oil preparations. In adults, independent predictors of supplement use included being female, increasing age, being born outside Australia and other main English-speaking countries, having a higher education level, having a healthy BMI compared to those who were obese, being physically active, and being a non-smoker. To our knowledge, this is the first detailed investigation of dietary supplement use in a nationally-representative sample of the Australian population. Future studies investigating the contribution of supplements to overall dietary intakes of vitamins, minerals, and omega-3 fatty acids are warranted.
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Project description:Introduction:Although a large body of research has identified effective models of transitional care, questions remain about the optimal translation of this knowledge into practice. In Australia, the introduction of a model of consumer-directed care uniquely challenges the practice of integrated care transitions for older adults. This study aimed to identify strengths and weaknesses in transitional care for older adults in an Australian setting by describing healthcare practitioners' experiences of care provision. Methods:The study used a qualitative design in two phases: 1) semi-structured interviews, 2) one focus group. The setting comprised one public health network and five community services in urban Australia. In Phase 1, health practitioners across settings were interviewed about their experience of transitional care. Phase 2 sought feedback about the Phase 1 findings from different practitioners. All data were thematically analysed. Findings:In Phase 1), 48 healthcare practitioners were interviewed across multiple settings. Few participants were aware of the introduction of consumer-directed care in community aged care. Four main themes were identified: 'Rapid and safe care transition', 'Discussing as a team', 'Questioning the discharge', and 'Engaging patients and carers'. In Phase 2), seven participants from different settings reviewed and endorsed the findings from Phase 1. Discussion and conclusions:Findings indicate that healthcare practitioners use a range of communication and coordination processes in optimising integrated transitional care. Although participants involved their patients in transitional care planning, most participants were unaware of the recent implementation of consumer-directed care. In contexts of community-based care shaped by multidisciplinary, sub-acute and CDC models, care integration must focus on improved communication with patients and carers to ascertain their needs and to support their increased responsibility in their care transitions.
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Project description:The burden of inflammatory bowel disease (IBD) in Australia is increasing but national data about the current prevalence are limited. We aimed to estimate the prevalence of IBD (including Crohn's disease, ulcerative colitis and unspecified IBD) as well as Crohn's disease and ulcerative colitis separately in a general practice population in Australia. We also assessed risk factors associated with Crohn's disease and ulcerative colitis. We conducted a cross-sectional study using data from MedicineInsight, a national database of general practice electronic health records, from 1 July 2017 to 30 June 2019. The prevalence of IBD was calculated and stratified by sociodemographic characteristics. Logistic regression analysis was conducted to assess risk factors associated with Crohn's disease and ulcerative colitis. The study comprised 2,428,461 regular patients from 481 practices. The estimated crude prevalence of IBD was 653 per 100,000 patients; Crohn's disease was 306 per 100,000 and ulcerative colitis was 334 per 100,000. Males were independently associated with a lower risk of Crohn's disease (OR: 0.86; 95% CI: 0.81, 0.90) but a greater risk of ulcerative colitis (OR: 1.12; 95% CI: 1.06, 1.17) than females. Compared to non-smokers, patients who were current smokers were associated with a greater risk of Crohn's disease (OR: 1.13; 95% CI: 1.04, 1.23) but a lower risk of ulcerative colitis (OR: 0.52; 95% CI: 0.47, 0.57). Other factors positively associated with both Crohn's disease and ulcerative colitis were age (≥ 25 years), non-Indigenous status and socioeconomic advantage. Our findings provide a current estimate of the prevalence of IBD, Crohn's disease and ulcerative colitis in a large national general practice population in Australia and an assessment of the factors associated with Crohn's disease and ulcerative colitis. These data can assist in estimating the health burden and costs, and planning for health services.
| S-EPMC8158877 | biostudies-literature
Project description:Bertolotti's syndrome (BS) refers to the possible association between the congenital malformation lumbosacral transitional vertebra (LSTV), and low back pain (LBP). Several treatments have been proposed including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion. The aim of this review was to compare the clinical outcomes in previous trials and case reports for these treatments in patients with LBP and LSTV. A PubMed search was conducted. We included English studies of patients diagnosed with LSTV treated with steroid injection, laminectomy, spinal fusion or resection of the transitional articulation. Of 272 articles reviewed 20 articles met the inclusion criteria. Their level of evidence were graded I-V and the clinical outcomes were evaluated. Only 1 study had high evidence level (II). The remainders were case series (level IV). Only 5 studies used validated clinical outcome measures. A total of 79 patients were reported: 31 received treatment with steroid injections, 33 were treated with surgical resection of the LSTV, 8 received lumbar spinal fusion, and 7 cases were treated with laminectomy. Surgical management seems to improve the patient's symptoms, especially patients diagnosed with "far out syndrome" treated with laminectomy. Clinical outcomes were more heterogenetic for patient's treated with steroid injections. The literature regarding BS is sparse and generally with low evidence. Non-surgical management (e.g., steroid injections) and surgical intervention could not directly be compared due to lack of standardization in clinical outcome. Generally, surgical management seems to improve patient's clinical outcome over time, whereas steroid injection only improves the patient's symptoms temporarily. Further studies with larger sample size and higher evidence are warranted for the clinical guidance in the treatment of BS.
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Project description: Not available
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