Division of Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia.
Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
J Anat. 2023 Aug;243(2):311-318. doi: 10.1111/joa.13865. Epub 2023 Apr 6.
Transitional vertebrae at the thoracolumbar region are called thoracolumbar transitional vertebrae (TLTV) and retain physical features from the thoracic and lumbar regions. Since TLTV were first classified 40 years ago, there has been much discrepancy regarding its features, identification and clinical relevance. Vertebral body levels are used in the medical field as a frame of reference to locate specific organs, vessels, nerves or landmarks. Any numeric variation or deviation in the vertebral column may lead to clinical errors. Previous findings have suggested a high association between numeric variation and the presence of TLTV. Therefore, the aim of this study was to identify the types of TLTV observed and to identify any possible associated numeric variation in the vertebral column. This study also aimed to validate the established technique to quantitatively differentiate TLTV from T12 and L1 at the thoracolumbar junction using skeletal remains from a South African population group. Skeletal remains (n = 187) remains from the Pretoria bone collection were assessed. Measurements were taken of the angle of the superior zygapophyseal processes of the last thoracic vertebra (T12), the first lumbar (L1), and identified TLTV. The results indicate a TLTV prevalence of 35% (n = 66/187). The results show that each vertebral type (T12, L1, TLTV) fall into independent confidence intervals: T12 is 188° ± 9.22 (CI: 187° < μ < 189.6°), 110° ± 7.52 (CI: 109.2° < μ < 111.3°) in L1, and 135° ± 24.51 (CI: 130.4° < μ < 139.1°) in the TLTV. This study observed that 70% of cases with TLTV was associated with numeric variation in the spine, both homeotic and meristic and that TLTV has a 35% prevalence. The results clearly show that quantitative morphometric analysis can effectively differentiate TLTV from other vertebral types at the thoracolumbar junction in skeletal remains.
胸腰椎区的过渡椎骨称为胸腰椎过渡椎骨（TLTV），保留了来自胸腰椎区的物理特征。自 40 年前首次对 TLTV 进行分类以来，其特征、识别和临床相关性一直存在很大差异。在医学领域，椎体水平被用作参考框架来定位特定的器官、血管、神经或地标。脊柱的任何数值变化或偏差都可能导致临床错误。先前的研究结果表明，数值变化与 TLTV 的存在高度相关。因此，本研究的目的是确定观察到的 TLTV 类型，并确定脊柱中可能存在的任何相关数值变化。本研究还旨在验证使用南非人群骨骼遗骸定量区分胸腰椎交界处 TLTV 与 T12 和 L1 的既定技术。评估了比勒陀利亚骨骼收藏中的骨骼遗骸（n=187）。测量了最后一个胸椎（T12）、第一个腰椎（L1）和已识别的 TLTV 的上关节突的角度。结果表明 TLTV 的患病率为 35%（n=66/187）。结果表明，每种椎骨类型（T12、L1、TLTV）都落入独立的置信区间内：T12 为 188°±9.22（CI：187°<μ<189.6°），110°±7.52（CI：109.2°<μ<111.3°）在 L1 中，而在 TLTV 中为 135°±24.51（CI：130.4°<μ<139.1°）。本研究观察到，70%的 TLTV 病例与脊柱的数值变化有关，既有同源性也有数量性，并且 TLTV 的患病率为 35%。结果清楚地表明，定量形态计量分析可以有效地在骨骼遗骸中区分胸腰椎交界处的 TLTV 与其他椎骨类型。
