Kershenovich Amir, Macias Oscar Malo, Syed Faiz, Davenport Caitlin, Moore Gregory J, Lock Joseph H
*Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania;‡Temple School of Medicine, Philadelphia, Pennsylvania;§Department of Neurosurgery, Hospital 20 de Noviembre, ISSSTE, Mexico City, Mexico;¶Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico;‖Department of Radiology, Geisinger Health System, Danville, Pennsylvania.
Neurosurgery. 2016 Jan;78(1):62-70. doi: 10.1227/NEU.0000000000001001.
The estimated prevalence of lumbar or sacral transitional vertebrae (LSTV) in the population is 4% to 30%. Few small patient series have studied the normal level of the conus medullaris (CM) in individuals with LSTV.
To determine, by using a large cohort of patients, whether individuals of all ages with LSTV have different CM positions in the spinal canal in comparison with the rest of the population with normal vertebral columns.
We performed an institutional retrospective analysis of spinal magnetic resonance images on individuals with LSTV of all ages, sexes, and pathologies during a 10-year period. Fifty-seven percent of patients (n = 467) had a lumbarized vertebra and 43% had sacralized vertebra (n = 355). Mean age at the time of the study was 55 ± 19 years (range 1-97 years). Fifty-two percent were male and 48% were female. Sixty percent of subjects with a sacralized vertebra were female, and 54.5% of those with a lumbarized vertebra were male (P = .001).
The CM in individuals with a lumbarized vertebra was seen to be lower at L1-2 to L2s, than un those with a sacralized vertebra where most conuses were at T12-L1 to L1s (P ≤ 0.001). The CM level was similarly distributed among sexes and ages.
In our series, the CM level, when lumbarization occurred, was lower, with a mean level at L1-L2, whereas a more superior mean level at T12-L1 was seen when sacralization occurred. CM level was not influenced by sex, age, or pathology other than tethered cords.
据估计，人群中腰骶部移行椎（LSTV）的患病率为4%至30%。很少有小样本患者系列研究过LSTV个体中脊髓圆锥（CM）的正常位置。
通过大量患者队列，确定所有年龄段的LSTV个体与其余脊柱正常的人群相比，其脊髓圆锥在椎管内的位置是否不同。
我们对10年间所有年龄、性别和病理类型的LSTV个体的脊柱磁共振成像进行了机构回顾性分析。57%的患者（n = 467）有腰椎化椎体，43%有骶椎化椎体（n = 355）。研究时的平均年龄为55±19岁（范围1 - 97岁）。52%为男性，48%为女性。骶椎化椎体的受试者中60%为女性，腰椎化椎体的受试者中54.5%为男性（P = 0.001）。
腰椎化椎体个体的脊髓圆锥在L1 - 2至L2水平比骶椎化椎体个体更低，骶椎化椎体个体的脊髓圆锥大多在T12 - L1至L1水平（P≤0.001）。脊髓圆锥水平在性别和年龄中分布相似。
在我们的系列研究中，发生腰椎化时脊髓圆锥水平较低，平均水平在L1 - L2，而发生骶椎化时平均水平在T12 - L1更高。除脊髓栓系外，脊髓圆锥水平不受性别、年龄或病理状态影响。
