Turk J Med Sci. 2019 Feb 11;49(1):184-189. doi: 10.3906/sag-1807-258.
BACKGROUND/AIM: The iliac crest tangent (ICT) has recently emerged as a reliable landmark to correctly number the lumbosacral transitional vertebrae (LSTV). We retrospectively evaluated the reproducibility and accuracy of the ICT as a landmark in subjects without disc degeneration.
Fifty-eight patients with LSTV [19 female, 41 (26–52) years] and 55 controls without LSTV [23 female, 40 (26–55) years] who had undergone spinal computed tomography were included. The ICT was drawn on the coronal images, with the cursor in the sagittal view set to the posterior ⅓ of the vertebral body located one level above the LSTV. When more than 1.25 vertebral body was counted below the ICT, the LSTV was considered as S1, otherwise it was considered as L5. The gold standard was counting the vertebrae craniocaudally.
The interobserver agreement was good for determining ICT level (Cohen’s kappa = 0.78, P < 0.001). The rate of correct numbering by ICT in the LSTV group was significantly less than in the controls (43.1% vs. 96.4%, respectively, P < 0.001). Patients with sacralization had a significantly lower correct numbering rate than patients with lumbarization (33.3% vs. 63.2%, respectively, P = 0.03).
ICT does not seem to be a reliable landmark for correct numbering of LSTV in patients with no intervertebral disc degeneration.
背景/目的：髂嵴切线（ICT）最近已成为正确标记腰骶移行椎（LSTV）的可靠标志。我们回顾性评估了 ICT 作为无椎间盘退变患者的标志的可重复性和准确性。
共纳入 58 例 LSTV 患者[女性 19 例，年龄 41（26-52）岁]和 55 例无 LSTV 对照组[女性 23 例，年龄 40（26-55）岁]，均接受了脊柱 CT 检查。ICT 在冠状图像上绘制，矢状视图中的光标设置在位于 LSTV 上方一个椎体水平的椎体后 1/3 处。当 ICT 下方计数超过 1.25 个椎体时，LSTV 被视为 S1，否则被视为 L5。金标准是从头侧到尾侧计数椎体。
确定 ICT 水平的观察者间一致性良好（Cohen’s kappa = 0.78，P < 0.001）。LSTV 组中 ICT 正确计数的比例明显低于对照组（分别为 43.1%和 96.4%，P < 0.001）。骶骨化患者的正确计数率明显低于腰椎化患者（分别为 33.3%和 63.2%，P = 0.03）。
在无椎间盘退变的患者中，ICT 似乎不是正确标记 LSTV 的可靠标志。
