Kiran Nandivada’s Stuck Blade in a Grinder Jar Degenerative Cascade by LSTV at L5-S1  

作　　者：Venkata Satya Kumar Kiran Nandivada Nadavinamani Shivanand Raghavendra Nandivada Nikhil Bharadwaja Moola Sohith Mahadeva Reddy Ahmed Usama Rizvi Venkata Satya Kumar Kiran Nandivada;Nadavinamani Shivanand Raghavendra;Nandivada Nikhil Bharadwaja;Moola Sohith Mahadeva Reddy;Ahmed Usama Rizvi(Nandivada Ortho Spine Surgeon & Rheumatologist, Abu Dhabi, United Arab Emirates;Senior Orthopedic Surgeon & Rheumatologist, Abu Dhabi, United Arab Emirates;General Practitioner, Visakhapatnam, India;Department of Medicine, Kamineni Institute of Medical Sciences, Telangana, India;Department of Medicine, Tbilisi State Medical University, Tbilisi, Georgia)

机构地区：[1]Nandivada Ortho Spine Surgeon & Rheumatologist, Abu Dhabi, United Arab Emirates [2]Senior Orthopedic Surgeon & Rheumatologist, Abu Dhabi, United Arab Emirates [3]General Practitioner, Visakhapatnam, India [4]Department of Medicine, Kamineni Institute of Medical Sciences, Telangana, India [5]Department of Medicine, Tbilisi State Medical University, Tbilisi, Georgia

出　　处：《Open Journal of Orthopedics》2024年第1期12-21,共10页矫形学期刊（英文）

摘　　要：Background: Mario Bertolotti, (1917) described LSTV-Lumbar spinal transitional vertebra as Bertolotti Syndrome a century ago and associated low back pain with it. Yet, it needs to be given significance in general orthopaedic practice even now, and radiologists underreport it. LSTV is a congenital anatomical anomaly that Castellvi classified into four varying types. Purpose: I titled this phenomenon “Kiran Nandivada’s stuck blade in a grinder jar degenerative cascade by LSTV at L5-S1” to clearly explain how an abnormal mega-transverse apophysis with its various variations affects the weight-bearing mechanics as the L5-S1 which is a vital junction where the maximum body weight is directed into both the sacroiliac joints and if a transitional vertebra occurs it becomes detrimental and abnormally redirects the load-bearing forces and leads to a progressive degenerative cascade both proximally and distally. As the L5 vertebral rotations and other movements of flexion, extensions, lateral flexion are stuck like a bent grinder blade, the other areas of the region are damaged progressively as the pelvis, just like the grinder motor tries to move it, resulting in overheating and maybe even a burnout results in the form of facet arthritis, disc degeneration in the normal disc above, the transitional disc at L5-S1, foraminal osteophytes causing radiculopathy, sacroiliac joint arthritis. Material and Methods: Around 200 X-rays of children and adults with this congenital anomaly have been studied between 2020 and 2023. This is a retrospective study. Results: 1) Our study showed an Increased incidence of LSTV at 15%. 2) Patients ranged from asymptomatic, atypical lumbago to classical lumbago with sciatica and claudication. Findings supported facet and sacroiliac joint arthritis and the pain, relieved with physiotherapy, posture corrections, weight reduction, and lifestyle precautions, negating the need for local steroid injections, radiofrequency ablation or surgical excision as per our experience. Conclusion: Other dyspBackground: Mario Bertolotti, (1917) described LSTV-Lumbar spinal transitional vertebra as Bertolotti Syndrome a century ago and associated low back pain with it. Yet, it needs to be given significance in general orthopaedic practice even now, and radiologists underreport it. LSTV is a congenital anatomical anomaly that Castellvi classified into four varying types. Purpose: I titled this phenomenon “Kiran Nandivada’s stuck blade in a grinder jar degenerative cascade by LSTV at L5-S1” to clearly explain how an abnormal mega-transverse apophysis with its various variations affects the weight-bearing mechanics as the L5-S1 which is a vital junction where the maximum body weight is directed into both the sacroiliac joints and if a transitional vertebra occurs it becomes detrimental and abnormally redirects the load-bearing forces and leads to a progressive degenerative cascade both proximally and distally. As the L5 vertebral rotations and other movements of flexion, extensions, lateral flexion are stuck like a bent grinder blade, the other areas of the region are damaged progressively as the pelvis, just like the grinder motor tries to move it, resulting in overheating and maybe even a burnout results in the form of facet arthritis, disc degeneration in the normal disc above, the transitional disc at L5-S1, foraminal osteophytes causing radiculopathy, sacroiliac joint arthritis. Material and Methods: Around 200 X-rays of children and adults with this congenital anomaly have been studied between 2020 and 2023. This is a retrospective study. Results: 1) Our study showed an Increased incidence of LSTV at 15%. 2) Patients ranged from asymptomatic, atypical lumbago to classical lumbago with sciatica and claudication. Findings supported facet and sacroiliac joint arthritis and the pain, relieved with physiotherapy, posture corrections, weight reduction, and lifestyle precautions, negating the need for local steroid injections, radiofrequency ablation or surgical excision as per our experience. Conclusion: Other dysp

关 键 词：LSTV Bertolotti Syndrome Transitional Vertebra Facet Tropism Congenital Dysplasia 

分 类 号：R24[医药卫生—中医临床基础]