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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).