Spinal Enumeration by Morphologic Analysis of Spinal Variants: Comparison to Counting in a Cranial-To-Caudal Manner.
10.3348/kjr.2018.19.6.1140
- Author:
Sam YUN
1
;
Sekyoung PARK
;
Jung Gu PARK
;
Jin Do HUH
;
Young Gyung SHIN
;
Jong Hyouk YUN
Author Information
1. Department of Radiology, Kosin University Gospel Hospital, Busan 49267, Korea. cordialsk@kosin.ac.kr
- Publication Type:Original Article
- Keywords:
Spine;
Anatomic variation;
Lumbar vertebra;
Enumeration;
Thoracolumbar transitional vertebra;
Computed tomography
- MeSH:
Anatomic Variation;
Female;
Humans;
Male;
Spine
- From:Korean Journal of Radiology
2018;19(6):1140-1146
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To compare the spinal enumeration methods that establish the first lumbar vertebra in patients with spinal variants. MATERIALS AND METHODS: Of the 1446 consecutive patients who had undergone computed tomography of the spine from March 2012 to July 2016, 100 patients (62 men, 38 women; mean age, 47.9 years; age range, 19–88 years) with spinal variants were included. Two radiologists (readers 1 and 2) established the first lumbar vertebra through morphologic analysis of the thoracolumbar junction, and labeled the vertebra by counting in a cranial-to-caudal manner. Inter-observer agreement was established. Additionally, reader 1 detected the 20th vertebra under the assumption that there are 12 thoracic vertebra, and then classified it as a thoracic vertebra, lumbar vertebra, or thoracolumbar transitional vertebra (TLTV), on the basis of morphologic analysis. RESULTS: The first lumbar vertebra, as established by morphologic analysis, was labeled by each reader as the 21st segment in 65.0% of the patients, as the 20th segment in 31.0%, and as the 19th segment in 4.0%. Inter-observer agreement between the two readers in determining the first lumbar vertebra, based on morphologic analysis, was nearly perfect (κ value: 1.00). The 20th vertebra was morphologically classified as a TLTV in 60.0% of the patients, as the first lumbar segment in 31.0%, as the second lumbar segment in 4.0%, and as a thoracic segment in 5.0%. CONCLUSION: The establishment of the first lumbar vertebra using morphologic characteristics of the thoracolumbar junction in patients with spinal variants was consistent with the morphologic traits of vertebral segmentation.
