Aims and objectives
Investigate the reliability of spinal attachments of Piriformis and Psoas major muscles as landmarks for lumbar spine numbering.
Assess a clinically well known but radiologically not well investigated parameter for the vertebral enumeration purpose; the iliac crest level.
Study the spinal attachment level of Ilio-lumbar ligament.
Assess the outcome of combining more than one landmark,
and if this can increase the reliability.
Methods and materials
Non-randomized retrospective cross-sectional study.
IRB/MRC approved.
Inclusion criteria: Patients of both genders (Ages 18-64 years old) who had been investigated by MRI of the whole spine.
Exclusion criteria: Incomplete MRI studies like unavailable coronal localizer.
Study included MRI examinations between 1/1/2017-1/3/2018.
Patients were divided as having a transitional lumbosacral vertebra (LSV)which may be either sacralization and lumbarization,
and a similar number of control group of patients with no transitional vertebra.
MRI examinations were used for assessment of lumbar spine numbering using the parameters namely:
Topmost...
Results
Total number of cases: 60
Cases with transitional LSV (Case group):30
Cases with Sacralization: 20
Cases with Lumbarization: 10
Cases without transitional LSV (Control group): 30
Demographics:
Gender: 31 males (51.6%) and 29 (48.4%) females.
Age: 18-64 (mean age 46)
Piriformis muscle topmost attachment:
Piriformis Attachment site
Normal
Sacralization
Lumbarization
S1
0
0
0
S2
16
20
0
S3
14
0
9
S4
0
0
1
In the case and control groups the Piriformis muscle was attachedat S2 and S3 vertebral levels.
In the control...
Conclusion
Piriformis and psoas major muscle topmost attachments,
iliac crest level and ilio-lumbar ligamentattachmenthad significant overlap between normal control and transitional LSV case group,
using the gold standard of enumeration from C2 downwards.
These cannot be used to definitely determine if a transitional LSV existed for sure when only lumbosacral spine imaging is available,
and hence were not proven to be reliable for spine enumeration neither as a single parameter nor in combination.
However,
in the case group these parameters were at distinctlyhigher levels in Sacralization...
Personal information
Dr.
Alaa Abdulsattar Al-Taie
M.B.Ch.B,
CABMS-RAD,
Musculoskeletal Radiology Clinical Fellowship.
Associate Consultant Musculoskeletal Radiologist,
Hamad Medical Corporation,
Doha,
Qatar.
Email:
[email protected]
Dr.
Vinu Mathew
MD,
Radiology Resident,
Clinical Imaging Department,
Hamad General Hospital,
Doha/QA.
Email:
[email protected]
Dr.
Surjith Vattoth
MBBS,
MD,
DMRD,
DNB,
FRCR,
DABR
Senior Consultant Neuroradiologist,
Hamad Medical Corporation,
Doha,
Qatar
Associate Professor of Clinical Radiology,
Weill Cornell Medicine-Qatar.
Email:
[email protected]
References
1.
Numbering of Lumbosacral Transitional Vertebrae on MRI: Role of the Iliolumbar Ligaments Ajronline.org/doi/pdf/10.2214/AJR.05.0415
2.
Lumbosacral Transitional Vertebrae: Classification,
Imaging Findings,
and Clinical Relevance.
Konin.
AJNR 31 Nov-Dec 2010
3.
Are Spinal or Paraspinal Anatomic Markers Helpful for Vertebral Numbering and Diagnosing Lumbosacral Transitional Vertebrae? 2014 Nov-Dec; 38(6):792-6.
doi: 10.1016/j.clinimag.2014.05.001.
Epub 2014 May 12.
4.
Is any landmark reliable in vertebral enumeration? A study of 3.0-Tesla lumbar MRI comparing skeletal,
neural,
and vascular markers.
Korean J Radiol.
2014 Mar-Apr; 15(2): 258–266. 10.3348/kjr.2014.15.2.258 PMCID: PMC3955794 Nil...