Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
Skeletal Radiol. 2021 Aug;50(8):1697-1704. doi: 10.1007/s00256-021-03722-x. Epub 2021 Feb 3.
Even though lumbosacral transitional vertebrae (LSTV) are one of the most common congenital anomalies of the spine, their effect on surrounding soft tissues is not well-studied. We therefore aimed at analyzing the association between LSTV and changes in volume, mass, symmetry, and degeneration of lumbar and trunk muscles.
Abdomen-pelvis CT scans were analyzed in patients with LSTV and a matched control group. LSTV were classified according to the Castellvi classification. Muscles were segmented from the remaining soft tissue and their cross-sectional area and volume were examined at five defined levels. Threshold segmentation was used to differentiate between muscle fibers and fat tissue. Matched pairs were compared using Wilcoxon rank sum tests. For comparison of categorical data, chi-squared tests were performed and for associations between the degree of fusion and muscle size and degeneration, Spearman's correlation coefficients were calculated. Inter- and intrarater reliabilities were evaluated by computing intraclass correlation coefficients.
Forty-six patients with LSTV and 46 controls were included. Muscle volume of the paraspinal and trunk muscles was significantly lower (707.0 cm vs. 809.7 cm, p < 0.001) and fatty muscle changes were significantly increased in all but the caudal paravertebral muscles of LSTV patients (M. psoas p < 0.04, M. quadratus lumborum p < 0.001, paravertebral muscles p = 0.011, M. rectus abdominis p < 0.001, M. obliquus abdominis p < 0.001). Correlations between the degree of Castellvi classification and muscle volume were significant (p = 0.001).
LSTV are associated with a reduction in muscle volume and an increase in muscle degeneration of both lumbar and trunk muscles.
腰骶移行椎（LSTV）是脊柱最常见的先天性畸形之一，但它们对周围软组织的影响尚未得到充分研究。因此，我们旨在分析 LSTV 与腰椎和躯干肌肉体积、质量、对称性和退行性变变化之间的关系。
对 LSTV 患者和匹配对照组的腹部-骨盆 CT 扫描进行分析。根据 Castellvi 分类对 LSTV 进行分类。将肌肉从剩余的软组织中分割出来，并在五个定义的水平上检查其横截面积和体积。使用阈值分割将肌肉纤维和脂肪组织区分开来。使用 Wilcoxon 秩和检验比较匹配对。对于分类数据的比较，进行卡方检验，对于融合程度与肌肉大小和退行性变之间的关联，计算 Spearman 相关系数。通过计算组内相关系数评估组内和组间可靠性。
共纳入 46 例 LSTV 患者和 46 例对照组。LSTV 患者的脊柱旁和躯干肌肉体积明显较小（707.0cm 比 809.7cm，p<0.001），除腰骶椎旁肌外，所有肌肉的脂肪化变化均明显增加（M. 腰大肌 p<0.04，M. 腰方肌 p<0.001，椎旁肌 p=0.011，M. 腹直肌 p<0.001，M. 腹外斜肌 p<0.001）。Castellvi 分类程度与肌肉体积之间存在显著相关性（p=0.001）。
LSTV 与腰椎和躯干肌肉的肌肉体积减少和肌肉退行性变增加有关。
