Lumbosacral transitional vertebra in spondylolisthesis: frequency, demographic findings, and clinical characteristics.

BACKGROUND: The association of LSTV with low back pain has been debated in the literature for nearly a century, but the relationship between LSTV and spondylolisthesis is still under discussion. There is currently no valid information about LSTV's prevalence in Iran. This study investigated the relationship between the presence of LSTV and lumbosacral spondylolisthesis regarding frequency, gender and age variation, grade and level of spondylolisthesis, and clinical signs and symptoms. METHODS: This cross-sectional study included spondylolisthesis patients admitted for surgery between March 2021 to December 2022. All patients underwent CT imaging. After evaluating medical records, the baseline data were collected. Patients were categorized into No LSTV, Sacralization, and Lumbarization groups. Demographic and clinical characteristics of the studied groups were compared using an independent T-test and Chi-Square. Multiple logistic regression was used to assess the age and sex variations between groups. RESULTS: 219 patients with a mean age of 57.07 ± 11.04 were included. A significant relationship was observed between the presence of sacralization and gender diversity with female predominance (P = 0.01). The level of spondylolisthesis and the presence of motor deficits (paresis) significantly differed among study groups (P < 0.05). Sacralization group exhibited a greater prevalence of higher grades of listhesis compared to the other groups. CONCLUSIONS: LSTV is frequently seen in spondylolisthesis patients. Sacralization is the common type of LSTV in spondylolisthesis patients, possibly leading to an increased risk for higher grades of vertebral slip and higher rates of motor deficit signs and symptoms. The presence of sacralization results in a significant increase in the incidence of higher levels of spondylolisthesis, especially the L4-L5*(sacralized L5) level. There is no relationship between age and the presence of LSTV in spondylolisthesis.

The Effect of Adding Dry Needling to Physical Therapy in the Treatment of Cervicogenic Headache: A Randomized Controlled Trial.

OBJECTIVE: To compare the long-term effect of adding real or sham dry needling with conventional physiotherapy in cervicogenic headache. DESIGN: A randomized controlled trial. SETTING: Physiotherapy Clinic, Rouhani Hospital of Babol University of Medical Sciences, Iran. SUBJECTS: Sixty-nine patients with cervicogenic headache. METHODS: Patients were randomly assigned into a control group (n = 23) receiving conventional physical therapy; a dry needling group (n = 23) receiving conventional physical therapy and dry needling on the cervical muscles; placebo needling group (n = 23) receiving conventional physical therapy and superficial dry needling at a point away from the trigger point. The primary outcome was the headache intensity and frequency. Neck disability, deep cervical flexor performance, and range of motion were secondary outcomes. Outcomes were assessed immediately after treatment and 1, 3, and 6 months later. RESULTS: Sixty-five patients were finally included in the analysis. Headache intensity and neck disability decreased significantly more in the dry needling compared to sham and control groups after treatment and during all follow-ups. The frequency of headaches also reduced more in the dry needling than in control and sham groups, but it did not reach statistical significance. Higher cervical range of motion and enhancement of deep cervical flexors performance was also observed in the dry needling compared to sham and control groups. CONCLUSION: Dry needling has a positive effect on pain and disability reduction, cervical range of motion, and deep cervical flexor muscles performance in patients with cervicogenic headache and active trigger points, although the clinical relevance of the results was small. TRIAL REGISTRATION: The trial design was registered in the Iranian Registry of Clinical Trials (www.irct.ir, IRCT20180721040539N1) before the first patient was enrolled.