Changes in Lumbosacral Anatomy and Vertebral Numbering in Patients with Thoracolumbar and/or Lumbosacral Transitional Vertebrae

Tatara, Yasunori; Niimura, Takanori; Sekiya, Takao; Mihara, Hisanori

doi:10.2106/jbjs.oa.20.00167

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…Secondly, this study excluded volunteers with an abnormal vertebral count or transitional anatomy. Previous literature has shown that a sizeable portion of people exhibits such abnormal or transitional vertebral anatomy 21–23. Thus, the findings reported in this study apply to asymptomatic volunteers but not to those with abnormal or transitional vertebral anatomy.…”

Section: Discussionmentioning

confidence: 49%

Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Shen

Sardar

Huec

et al. 2023

Spine

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Study Design. Prospective, cross-sectional cohort study. Objective. To determine the relationship between lumbar shape and sagittal parameters. Summary of Background Data. Understanding the lumbar shape is vital for deformity surgery. Normative sagittal parameters and spine shape remain unstudied in large, multiethnic, asymptomatic cohorts. Materials and Methods. A prospective, cross-sectional cohort of 468 asymptomatic volunteers between 18 and 80 years was enrolled across 5 countries. Demographic data and radiographic parameters such as pelvic incidence (PI) were collected. Pearson correlation test and linear regression were used to find the relationship between lumbar lordosis (LL) and other parameters. One-way analysis of variance and Welch 2-sample t test were performed to compare lumbar shape across such categories as PI and lumbar apex followed by post hoc Bonferroni correction if needed.Results. PI was moderately correlated with proximal lumbar lordosis (pLL) (r = −0.54) and weakly correlated with distal lumbar lordosis (dLL) (r = −0.16). Thoracic kyphosis (T1-T12) was moderately correlated with pLL (r = −0.35) and dLL (r = −0.29). dLL was moderately correlated with LL (r = 0.64). 2.6% (12/468) of subjects had lumbar apex at L2, 40.2% (188/468) at L3, 56.6% at L4 (265/468), and 0.6% (3/468) at other levels. Mean PI was different between volunteers with the apex at L3 and L4. A lower mean PI was associated with the apex at L4 (49.0°), whereas a higher mean PI was associated with the apex at L3 (55.8°). The mean PI−LL mismatch for volunteers was −5.4°with a range from −35°to 39.7°. PI−LL mismatch increased from a mean of −10.1°i n volunteers with low PI to a mean of 2.2°in volunteers with high PI. Age was not correlated with LL (P = 0.84). Conclusions. In asymptomatic adult volunteers, pLL showed a moderate correlation with PI and increased with PI, whereas dLL showed a weak correlation. The lumbar apex migrated proximally with increasing PI. Segmental lordosis and apex position instead of solely global lordosis should be emphasized.

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Section: Discussionmentioning

confidence: 49%

Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Shen

Sardar

Huec

et al. 2023

Spine

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“…Scans were excluded if there was any evidence of previous spinal, pelvic or hip joint surgery or fracture, tumor or infection that could preclude analysis of either vertebral, or pelvic parameters. Scans were also excluded if there was an abnormal vertebral body count of if there was transitional anatomy as this could influence the pelvic parameters (Tatara et al, 2021).…”

Section: Methodsmentioning

confidence: 99%

Comparison of L5 pedicle morphology in patients with and without L5 spondylolysis

Baker

2021

Clinical Anatomy

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Only a small number of studies have reported on L5 pedicle morphology in the presence of spondylolisthesis let alone isolated spondylolysis and findings are therefore variable. The aim of this radiographic study was to analyze L5 pedicle morphology in the presence and absence of L5 spondylolysis. The was a retrospective crosssectional analysis of computed tomographic (CT) imaging. Assessment of the L5 pedicle morphology (height, width, length, transverse angle and screw length) were measured in patients with and without L5 spondylolysis. Pelvic measures including pelvic incidence, sacral anatomic orientation and sacral table angle were recorded. Patients were matched for age and gender. Twenty-three patients with spondylolysis were matched to 46 patients without. The presence of spondylolysis alone did not have a significant influence on either pelvic or pedicle morphologic parameters. Only with the presence of associated spondylolisthesis was there a difference noted with an increase in pedicle length observed. Correlation analysis suggested further morphologic changes may result with increased remodeling. Isolated spondylolysis at L5 appears to have little influence on pedicle morphology in this CT-based analysis.Morphologic changes appear likely to become significant only with associated spondylolisthesis and associated remodeling.

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“…Результаты мультиспиральной компьютерной томографии более наглядны, и на их основании, как правило, выносят заключение о типе переходных позвонков, в том числе в грудопоясничном отделе [32,50,51]. По мнению Y. Tatar и соавт., аксиальные сканы иллюстрируют морфологические особенности существующей патологии, в то время как сагиттальные изображения дают информацию о пояснично-крестцовой анатомии [52]. Применение в диагностических целях магнитно-резонансной томографии позволяет получить достоверную информацию о наличии и тяжести экстрафораминального стеноза, импиджмента и отёка корешков спинномозговых нервов L 4 , L 5 , S 1 [53][54][55].…”

Section: объективная диагностикаunclassified

Transitional lumbosacral vertebrae

Скрябин

2023

Kazan Med J

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Transitional lumbosacral vertebrae in the form of SI lumbarization and LV sacralization are classified as spinal anomalies. In the domestic medical literature, there are few publications devoted to these pathological conditions. In the course of a study of the available literature on the problem of transitional lumbosacral vertebrae, it was found that the frequency of cases of transitional lumbosacral vertebrae diagnosis ranges from 4 to 30% of clinical cases. The share of patients with lumbar vertebrae accounts for an average of 40% of cases, the share of patients with sacralization of the vertebrae is 60% of clinical observations. Mutations in the Hox gene are considered to be the trigger for the development of pathology, and pain is usually the leading clinical symptom. Plain radiography, computed tomography and magnetic resonance imaging are used to diagnose the pathology. Radiation imaging of the entire spine is required to eliminate errors in vertebrae counting. The type of pathology is determined using various classifications. As conservative therapeutic agents, drug blockades applying anesthetics and hormonal drugs are used. The arsenal of surgical interventions includes resection of the enlarged transverse process of the supracacral vertebra, decompression of stenotic intervertebral foramina, impulsive radiofrequency ablation, and posterior fusion. Measures for the prevention of pathology are not currently developed.

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Changes in Lumbosacral Anatomy and Vertebral Numbering in Patients with Thoracolumbar and/or Lumbosacral Transitional Vertebrae

Cited by 15 publications

References 19 publications

Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Comparison of L5 pedicle morphology in patients with and without L5 spondylolysis

Transitional lumbosacral vertebrae

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