Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, Suite 5165, Baltimore, MD 21287, USA.
Radiology. 2011 Apr;259(1):196-202. doi: 10.1148/radiol.11081511.
To verify iliolumbar ligament (ILL) location, to evaluate magnetic resonance (MR) imaging morphologic features for detecting lumbosacral transitional vertebrae (TVs) (LSTVs), and to determine whether transitional situations are associated with anomalous vertebral numbering.
Investigational review board approval was obtained for this HIPAA-compliant retrospective study. A review of 147 subjects was performed by using spine radiography as the reference standard to determine total and segmental vertebral count and transitional anatomy. Thoracolumbar TVs (TLTVs) and LSTVs were identified. The lumbosacral intervertebral disk angle (LSIVDA), defined as the angle between the endplates, was measured, S1-2 disk morphology was rated according to the classification by O'Driscoll et al, and the ILL level was determined from MR images. Statistical analysis was performed by using χ(2) tests for dichotomous and ordinal variables and the t test for continuous variables.
An anomalous total number of vertebrae were present in 12 (8.2%) of 147 subjects. The ILL was identified in 126 (85.7%) of 147 subjects and was present at L5 in 122 (96.8%) subjects; the remaining four (3.2%) subjects had an anomalous total number of vertebrae. A complete S1-2 intervertebral disk was associated with LSTVs (P = .004); however, LSIVDA was not (P = .2). TLTVs were present in six (4.1%) and LSTVs were present in 22 (15.0%) of 147 subjects. Both were present in four (2.7%) subjects. The presence of a TLTV was associated with a higher incidence of a concomitant LSTV and vice versa (P < .001; odds ratio [OR], 13.7; 95% confidence interval [CI]: 2.7, 68.4]). A TLTV was not associated with an anomalous total number of vertebrae (P = .46), but an LSTV was (P < .001; OR, 7.4; 95% CI: 2.2, 24.8).
The ILL denotes the lowest lumbar vertebra, which does not always represent L5. A well-formed, complete S1-2 intervertebral disk is associated with LSTVs, but alteration in LSIVDA is not. LSTVs are associated with anomalous vertebral numbering.
验证髂腰韧带（ILL）的位置，评估磁共振成像（MR）形态学特征以检测腰骶部过渡椎（LSTV），并确定过渡情况是否与异常椎体编号有关。
本 HIPAA 合规性回顾性研究获得了机构审查委员会的批准。通过脊柱 X 线摄影作为参考标准，对 147 例受试者进行了回顾性分析，以确定总椎体和节段椎体计数以及过渡解剖结构。确定胸腰椎过渡椎（TLTV）和 LSTV。测量腰骶椎间盘角（LSIVDA），定义为终板之间的角度，根据 O'Driscoll 等人的分类对 S1-2 椎间盘形态进行评分，并从 MR 图像确定 ILL 水平。使用 χ(2)检验进行二分类和有序变量分析，连续变量采用 t 检验。
147 例受试者中有 12 例（8.2%）存在异常总椎体数。147 例受试者中有 126 例（85.7%）可识别 ILL，122 例（96.8%）受试者的 ILL 位于 L5；其余 4 例（3.2%）受试者的异常总椎体数。完整的 S1-2 椎间盘与 LSTV 相关（P=.004）；然而，LSIVDA 不相关（P=.2）。TLTV 存在于 6 例（4.1%）和 LSTV 存在于 22 例（15.0%）受试者中。四例（2.7%）受试者同时存在 TLTV 和 LSTV。TLTV 与同时存在的 LSTV 发生率较高相关，反之亦然（P<.001；比值比[OR]，13.7；95%置信区间[CI]：2.7，68.4）。TLTV 与异常总椎体数无关（P=.46），但 LSTV 相关（P<.001；OR，7.4；95% CI：2.2，24.8）。
ILL 表示最低的腰椎，并不总是代表 L5。形态良好、完整的 S1-2 椎间盘与 LSTV 相关，但 LSIVDA 改变无关。LSTV 与异常椎体编号有关。
