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A rapid method to identify lumbarization on lumbar spine radiography and computed tomography
Bingxuan Wu1, Bowei Xiao1, Minghao Wu2
1Department of Orthopaedic Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Summary
Lumbosacral transitional vertebrae (LSTV) are common. This study identified rapid imaging methods using anterior superior angle (ASA), posterior angle (PA), and iliac crest line (ICL) to detect lumbarization, a type of LSTV.
Area of Science:
- Radiology
- Spinal Anatomy
- Congenital Anomalies
Background:
- Lumbosacral transitional vertebrae (LSTV) are common congenital anomalies.
- They involve sacralization or lumbarization and are a frequent cause of wrong-level surgery.
Purpose of the Study:
- To identify morphological characteristics for rapid detection of LSTV on lumbar spine imaging.
- To differentiate between lumbarization (LZ) and sacralization (SZ) of LSTV.
Main Methods:
- Retrospective case-control study of 909 patients undergoing lumbar CT and whole-spine radiography.
- Measurements included anterior superior angle (ASA), posterior angle (PA), and iliac crest line (ICL) location.
- Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance.
Main Results:
- LSTV prevalence was 11.6% (LZ 8.4%, SZ 3.2%).
- Lumbarization (LZ) showed significantly lower ASA and PA, and higher prevalence of high ICL compared to controls.
- Combined ASA, PA, and ICL showed good to excellent performance in differentiating LZ from control and SZ groups.
Conclusions:
- Lumbarization can be rapidly identified on lumbar spine imaging.
- High ICL with small ASA and PA suggests lumbarization, warranting whole-spine radiography for confirmation.
Keywords:
Anatomical variationLumbarizationLumbosacral regionLumbosacral transitional vertebraeWrong-level surgeryMore Related Videos
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