Differences in vertical mid-vertebral angles: with LSTV

Case contributed by Dr Subash Thapa

Mid-sagittal and volume render CT image of a patient with lumbosacral transitional vertebra (LSTV) with solid bony bridge.

Note the two most caudal segment angles:

  • Caudal angle = 22.5°
  • Cephalad angle = 40.0°
  • Diff-VMVA (caudal minus cephalad) = -17.5°

Diff-VMVA of ≤+10° suggests LSTV Castellvi type III or IV,1 i.e. solid bony bridge as in our case.

Volume render CT image shows complete fusion of bilateral transverse process with the adjacent sacral ala (Castellvi type IIIb).

Case Discussion

In case of lumbosacral transitional vertebra, the cephalad adjacent segment angle is similar or larger than the transitional caudal segment angle as in our case of Castellvi type IIIb.

Diff-VMVA of ≤+10° suggests LSTV Castellvi type III or IV 1.

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Case information

rID: 47533
Case created: 20th Aug 2016
Last edited: 24th Aug 2016
Inclusion in quiz mode: Excluded

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