Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Insights into Imaging
Published in: Insights into Imaging 1/2014

Open Access 01-02-2014 | Original Article

The prevalence of morphological changes in the thoracolumbar spine on whole-spine computed tomographic images

Authors: Aya Nakajima, Akihito Usui, Yoshiyuki Hosokai, Yusuke Kawasumi, Kenta Abiko, Masato Funayama, Haruo Saito

Published in: Insights into Imaging | Issue 1/2014

Login to get access

Abstract

Objectives

This article reviews the prevalence of lumbarisation, sacralisation and lumbar ribs, and their morphological relevance by evaluating multi-slice computed tomography (MSCT) images. These segment variations can cause miscounting of vertebrae at the lumbar spinal level.

Methods

A retrospective radiographic analysis of 226 cases scanned by MSCT prior to forensic autopsy was undertaken. MSCT scans of the entire spine were obtained. Radiological data were evaluated on a three-dimensional image workstation. Vertebral levels were determined by counting downward from the first cervical vertebra, based on the assumption of seven cervical, 12 thoracic and five lumbar vertebrae. The prevalence of lumbarisation, sacralisation and lumbar ribs was assessed.

Results

Lumbar ribs were observed in 13 of the 226 cases (5.8 %). Lumbarisation and sacralisation were observed in 14 cases (6.2 %) and six cases (2.7 %), respectively. Lumbar ribs were present in 11 of the 14 cases with lumbarisation, and in two of the 206 cases with normal lumbar vertebral configuration. Lumbarisation had a statistically significant association with lumbar ribs (p < 0.01).

Conclusions

There was a strong association between lumbar ribs and lumbarisation, with a resulting miscount rate for the lumbar spine of slightly less than 10 %.

Teaching points

  • Lumbarisation and sacralisation are observed 6.2 % and 2.7 %, respectively.
  • Thoracolumbar segment variations can cause a miscount rate for the lumbar spine of less than 10 %.
  • Lumbar rib is significantly associated to lumbarisation.
Literature
1.
Bron JL, van Royen BJ, Wuisman PI (2007) The clinical significance of lumbosacral transitional anomalies. Acta Orthop Belg 73:678–695PubMed
2.
Hahn PY, Strobel JJ, Hahn FJ (1992) Verification of lumbosacral segments on MR images: identification of transitional vertebrae. Radiology 182:580–581PubMedCrossRef
3.
Castellvi AE, Goldstein LA, Chan DPK (1984) Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine 9:493–495PubMedCrossRef
4.
O’Driscoll CM, Irwin A, Saifuddin A (1996) Variations in morphology of the lumbosacral junction on sagittal MRI: correlation with plain radiography. Skeletal Radiol 25:225–230PubMedCrossRef
5.
Hsieh CY, Vanderford JD, Moreau SR, Prong T (2000) Lumbosacral transitional segments: classification, prevalence, and effect on disk height. J Manipulative Physiol Ther 23:483–489PubMedCrossRef
6.
Erken E, Ozer HT, Gulek B, Durgun B (2002) The association between cervical rib and sacralization. Spine 27:1659–1664PubMedCrossRef
7.
Chang HS, Nakagawa H (2004) Altered function of lumbar nerve roots in patients with transitional lumbosacral vertebrae. Spine 29:1632–1635PubMedCrossRef
8.
Delport EG, Cucuzzella TR, Kim N et al (2006) Lumbosacral transitional vertebrae: incidence in a consecutive patient series. Pain Physician 9:53–56PubMed
9.
Elster AD (1989) Bertolotti’s syndrome revisited: transitional vertebrae of the lumbar spine. Spine 14:1373–1377PubMedCrossRef
10.
Hughes RJ, Saifuddin A (2004) Imaging of lumbosacral transitional vertebrae. Clin Radiol 59:984–991PubMedCrossRef
11.
Luoma K, Vehmas T, Raininko R et al (2004) Lumbosacral transitional vertebra: relation to disc degeneration and low back pain. Spine 29:200–205PubMedCrossRef
12.
Taskaynatan MA, Izci Y, Ozgul A et al (2005) Clinical significance of congenital lumbosacral malformations in young male population with prolonged low back pain. Spine 30:E210–E213PubMedCrossRef
13.
Tini PG, Wieser C, Zinn WM (1977) The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance. Rheumatol Rehabil 16:180–185PubMedCrossRef
14.
Otani K, Konno S, Kikuchi S (2001) Lumbosacral transitional vertebrae and nerveroot symptoms. J Bone Joint Surg Br 83-B:1137–1140CrossRef
15.
Peh WC, Siu TH, Chan JH (1999) Determining the lumbar vertebral segments on magnetic resonance imaging. Spine 24:1852–1855PubMedCrossRef
16.
Seçer M, Muradov JM, Dalgiç A (2009) Evaluation of congenital lumbosacral malformations and neurological findings in patients with low back pain. Turk Neurosurg 19:145–148PubMed
17.
Wigh RE, Anthony HF Jr (1981) Transitional lumbosacral discs: probability of herniation. Spine 6:168–171PubMedCrossRef
18.
Konin GP, Walz DM (2010) Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR Am J Neuroradiol 31:1778–1786PubMedCrossRef
19.
Carrino JA, Campbell PD Jr, Lin DC, Morrison WB, Schweitzer ME, Flanders AE, Eng J, Vaccaro AR (2011) Effect of spinal segment variants on numbering vertebral levels at lumbar MR imaging. Radiology 259:196–202PubMedCrossRef
20.
Wigh RE (1980) The thoracolumbar and lumbosacral transitional junctions. Spine 3:215–222CrossRef
21.
Standring S (2008) Development of the back: development of vertebrae. In: Newell RLM (ed) Gray’s Anatomy, 40th edn. Elsevier, London, pp 768–769
22.
Hughes RJ, Saifuddin A (2006) Numbering of lumbosacral transitional vertebrae on MRI: role of the iliolumbar ligaments. AJR Am J Roentgenol 187:59–66CrossRef
Metadata
Title
The prevalence of morphological changes in the thoracolumbar spine on whole-spine computed tomographic images
Authors
Aya Nakajima
Akihito Usui
Yoshiyuki Hosokai
Yusuke Kawasumi
Kenta Abiko
Masato Funayama
Haruo Saito
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 1/2014
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1007/s13244-013-0286-0

Other articles of this Issue 1/2014

Insights into Imaging 1/2014 Go to the issue

Pictorial Review

Solid malignant retroperitoneal masses—a pictorial review

Original Article

Impact of cross-enterprise data sharing on portable media with decentralised upload of DICOM data into PACS

Statement

ESR white paper on teleradiology: an update from the teleradiology subgroup

Meeting Report

European survey on imaging referral guidelines

Review

Imaging in Transcatheter Aortic Valve Replacement (TAVR): role of the radiologist

Pictorial Review

Struma ovarii: role of imaging?