Background: Lumbosacral transitional vertebrae (LSTV) is a congenital anomaly of the L5-S1 junction.A LSTV must be identified to ovoid surgical mistakes. Although LSTVs can be detected on all imaging modalities, i,e Ferguson radiographs (AP radiographs tilted cranially at 30°)., MR imaging is more frequently recommended. Aim:The goal of this study is to determine the superiority of MRI in identifying LSTV and related anomalies as well as to evaluate the contribution of anatomical landmarks to precise lumbar vertebral counting. Patients and Methods: This retrospective study included 53 Patients, with low back pain ,most of patients had done MRI as a first investigation collected from Benha University Hospitals and radiology Masr scan .
The Medical Benha University ethical approval number (MS 9.6.2020), Adult patients between 18 years to 66 years, attending MRI unit and fulfilling the inclusion and exclusion criteria recruited in the study. Sagittal T2, coronal T2, and proper axial T2 sections of the lumbar region using Siemens a 1.5-Tesla MRI. Results: This study establishes that MRI is gold standard in assessing LSTV and associated abnormalities. Approximately 28.4% of female patients and 26.4% of male patients had sacralization of the lumbar vertebra, whereas 26.4% of female patients and 18.8% of male patients had lumbarization, according to MRI features of the LSTV. Conclusion: MRI is a dependable and accurate method for identifying LSTV, associated abnormalities and surgical planning. The classification system for LSTV using MRI aids in management and improve the effectiveness of surgical intervention at the correct level