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Defining normal vertebral angulation at the thoracolumbar junction.

Michael B Crawford1, Andoni P Toms, Lee Shepstone

  • 1Department of Radiology, Norfolk and Norwich University Hospital, NHS Foundation Trust, Colney Ln., Norwich, Norfolk NR4 7UY, United Kingdom. Michael.crawford@nnuh.nhs.uk).

AJR. American Journal of Roentgenology
|June 23, 2009
PubMed
Summary

This study establishes the normal range for vertebral endplate angulation at T12 and L1 using Picture Archiving and Communication System (PACS) tools. Findings indicate a mean angle of approximately 4.5 degrees, with values over 10 degrees considered abnormal.

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Area of Science:

  • Radiology
  • Spine Imaging
  • Anatomy

Background:

  • Vertebral endplate angulation is a critical parameter in spinal assessment.
  • Standardized measurement of this angle is essential for accurate diagnosis and treatment planning.
  • Existing tools for measuring endplate angles on PACS workstations require validation.

Purpose of the Study:

  • To define the normal range of endplate angulation at the T12 and L1 vertebral levels.
  • To validate the accuracy of angle measurement tools available on Picture Archiving and Communication System (PACS) workstations.

Main Methods:

  • A cross-sectional study analyzed 200 lateral scout CT scans from 25- and 35-year-old patients.
  • Endplate angles at T12 and L1 were measured using a Cobb angle tool on PACS.
  • Cadaveric vertebrae (n=22) were used to compare CT-derived measurements with goniometer and caliper measurements.

Main Results:

  • The mean endplate angle was 4.34 degrees at T12 and 4.48 degrees at L1.
  • The normal range for T12 was -0.16 to 8.84 degrees, and for L1 was 0.22 to 8.74 degrees.
  • Strong correlation was found between direct and CT-derived measurements; no significant differences based on sex or age group.

Conclusions:

  • Widely available PACS workstation tools can reliably measure vertebral endplate angulation.
  • The normal range for T12 and L1 endplate angles is approximately 0 to 9 degrees.
  • An endplate angle of 10 degrees or more is considered outside the normal range.