Advanced Medical Imaging and Genetics (Amigenics), Inc., Las Vegas, Nevada, USA.
J Neurosurg Spine. 2010 Jan;12(1):47-55. doi: 10.3171/2009.7.SPINE09326.
When the number of lumbar and sacral vertebrae is being assessed, variations from typical lumbosacral anatomy may confuse the practitioner, potentially leading to significant clinical errors. In this study, the authors describe the statistical variation in lumbar spine anatomy in an outpatient imaging setting, evaluate the potential implications for clinical practice based on the variation in the number of lumbar-type vertebrae identified, and recommend a method for rapidly determining the number of lumbar spine vertebral bodies (VBs) in outpatients referred for lumbar spine MR imaging.
A total of 762 patients (male and female) who presented with low back-related medical conditions underwent whole-spine MR imaging in an outpatient setting.
The high-speed whole-spine evaluation was successful for determining the number of lumbar-type VBs in 750 (98%) of 762 consecutive patients. The sagittal whole-spine 3-T MR imaging system images obtained between the beginning of January 2005 and the end of February 2007 were reviewed. The VBs were counted successively from the level of C-2 inferiorly to the intervertebral disc below the most inferior lumbar-type VB. Numbers of disc herniations were also evaluated in the context of the number of VBs.
One in 5 of these outpatients did not have 5 lumbar-type vertebrae: 14.5% had 6; 5.3% had 4; and 1 (0.13%) had the rare finding of 3 lumbar-type vertebrae. Two-thirds of the individuals with 6 lumbar-type vertebrae were male and two-thirds of the individuals with 4 lumbar-type vertebrae were female. Sagittal whole-spine MR imaging can be performed rapidly and efficiently in the majority of patients (98%), and provides improved accuracy for the determination of the number of lumbar-type VBs. A supplementary coronal MR, Ferguson view radiograph or intraoperative fluoroscopic determination for the presence of lumbosacral transitional vertebrae may add additional information when indicated for clinical treatment or surgical planning.
在评估腰椎和荐骨数量时，腰骶解剖结构的变异可能会使医生感到困惑，从而导致严重的临床错误。本研究作者描述了门诊影像检查中腰椎解剖结构的统计学变异，根据所识别的腰椎型椎体数量的变化，评估其对临床实践的潜在影响，并推荐一种快速确定门诊患者腰椎脊柱椎体数量的方法，这些患者因腰椎脊柱问题接受 MRI 检查。
共对 762 例（男/女）患有与下背部相关疾病的患者进行了门诊全身 MRI 检查。
在 762 例连续患者中，750 例（98%）的高速全身评估成功确定了腰椎型 VB 的数量。回顾了 2005 年 1 月初至 2007 年 2 月底期间获得的矢状位全脊柱 3-T MR 成像系统图像。从 C-2 椎体下缘到最下方腰椎型 VB 下方的椎间盘，连续对 VB 进行计数。还评估了椎间盘突出症的数量与 VB 数量的关系。
这些门诊患者中，1/5 的患者没有 5 个腰椎型椎体：14.5%有 6 个；5.3%有 4 个；1 个（0.13%）有罕见的 3 个腰椎型椎体。6 个腰椎型椎体中有三分之二为男性，4 个腰椎型椎体中有三分之二为女性。在大多数患者中（98%），可以快速高效地进行矢状位全脊柱 MRI 检查，并为确定腰椎型 VB 的数量提供更高的准确性。当临床治疗或手术计划需要时，补充冠状位 MR、Ferguson 视图射线照相或术中透视确定腰骶过渡椎体可能会提供额外的信息。
