The abnormality of the number of ribs misleading incorrect vertebral segment identification during lumbar intervention - Two cases report -

Lee, Jun Ho; Lee, Kijae; Ki, Min-Jong; Kim, Myungjong; Doo, A Ram; Son, Ji-Seon

doi:10.17085/apm.2019.14.3.331

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Presence of lumbar rib may hinder percutaneous renal biopsy through the renal angle between the 12th thoracic rib and lumbar vertebra 40 . Absence of the 12th thoracic rib may result in incorrect vertebral segment identification during lumbar intervention 41 . A rare case of lung herniation has been reported as a complication secondary to absence of multiple ribs 42 .…”

Section: Figure Volume Contrast Ultrasonographic Images Demonstrating...mentioning

confidence: 99%

Ultrasonographic screening for fetal rib number anomalies

2020

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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Objective: To determine associations between fetal rib number anomalies detected on ultrasonography and chromosomal anomalies and other structural anomalies, and the outcome of affected pregnancies. Methods: All cases of fetal rib number anomalies referred to the Prenatal Diagnosis Clinic of Queen Elizabeth Hospital between 1 January 2016 and 31 December 2019 were reviewed. Fetal ribs were examined by static threedimensional multiplanar or volume contrast ultrasonography. Genetic counselling was offered. The prenatal and postnatal records were reviewed. Results: 21 fetuses with rib number anomalies were identified over 4 years. The most common presentation was unilateral or bilateral absence of the 12th thoracic rib (n=12, 57.1%), followed by the presence of lumbar rib (n=6, 28.6%) and the presence of cervical rib (n=3, 14.3%). Three (14.3%) fetuses were identified to have anomalies in other systems: unilateral absence of nasal bone (n=1) and minor vascular anomalies (n=2). One patient with multiple anomalies of the fetus underwent amniocentesis, and the chromosomal microarray analysis was normal. Postnatally, 13 babies had chest radiographs taken. Two were confirmed to have normal number of ribs. Prenatal and postnatal findings were consistent in 6 (46.2%) babies. Conclusion: Fetal rib number anomalies were an isolated finding in most cases. The prognosis is good in the absence of other major anomalies. The accuracy of prenatal ultrasonography appears to be low. These findings do not support routine counting of fetal rib number in second-trimester ultrasonography.

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Section: Figure Volume Contrast Ultrasonographic Images Demonstrating...mentioning

confidence: 99%

Ultrasonographic screening for fetal rib number anomalies

2020

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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“…However, the accurate identification of the TLTV is not easy in clinical practice when only a simple X-ray or fluoroscopic image is obtained during interventional procedures, because the morphology of TLTV can’t be easily figured out especially in the geriatric patients with severe osteoporosis. Furthermore, the existence of concurrent LSTV or abnormal rib count (11 or 13 ribs) may lead to be more difficult to distinguish the first lumbar vertebra from TLTV even with imaging the entire spine [ 6 , 7 ]. Therefore, it is helpful to understand the clinical characteristics of the patients with spinal variation such as TLTV and LSTV or abnormal rib count.…”

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confidence: 99%

The prevalence and clinical significance of transitional vertebrae: a radiologic investigation using whole spine spiral three-dimensional computed tomographic images

et al. 2020

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Background Errors in counting spinal segments are common during interventional procedures when there are transitional vertebrae. In this study, we investigated the prevalence of the transitional vertebrae including thoracolumbar transitional vertebra (TLTV) and lumbosacral transitional vertebrae (LSTV). The relationship between the existence of TLTV and abnormal rib count or the existence of LSTV were also evaluated. Methods The vertebral levels were counted craniocaudally, starting from C1, based on the assumption of 7 cervical, 12 thoracic, and 5 lumbar vertebrae, using whole spine spiral three-dimensional computed tomographic images. The 20th and 25th vertebrae were defined as L1 and S1, respectively. Results In total, 150 patients had TLTV, with a prevalence of 11.2% (150/1,340). LSTV was observed in 111 of 1,340 cases (8.3%). Sacralization was observed in 68 of 1,340 cases (5.1%) and lumbarization in 43 of 1,340 cases (3.2%). There was a significant relationship between the existence of TLTV and the abnormal rib count (odds ratio [OR]: 117.26, 95% confidence interval [95% CI]: 60.77–226.27; P < 0.001) and LSTV (OR: 7.38, 95% CI: 3.99–13.63; P < 0.001). Conclusions Our study results suggest that patients with TLTV are more likely to have an abnormal rib count or LSTV. If a TLTV or LSTV is seen on the fluoroscopic image, a whole spine image is necessary to permit accurate numbering of the lumbar vertebra.

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The abnormality of the number of ribs misleading incorrect vertebral segment identification during lumbar intervention - Two cases report -

Cited by 2 publications

References 8 publications

Ultrasonographic screening for fetal rib number anomalies

Ultrasonographic screening for fetal rib number anomalies

The prevalence and clinical significance of transitional vertebrae: a radiologic investigation using whole spine spiral three-dimensional computed tomographic images

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