Lumbosakral geçiş vertebralarının semptomatik ve morfometrik analizi: yaş ve cinsiyete göre değerlendirmeler

Year 2024, Volume: 15 Issue: 3, 351 - 357, 30.09.2024

Koray Bingöl , Mithat Kerim Arslan

https://doi.org/10.18663/tjcl.1532934

Abstract

Amaç: Lumbosakral geçiş vertebraları (LSTV), bir omurun hem lumbal hem de sakral vertebra özelliklerini gösterdiği anatomik varyasyonlardır. Bu çalışma, LSTV'li hastalarda yaş ve cinsiyet farklılıklarını dikkate alarak, intervertebral disk yüksekliği (IVDh), vertebral foramenin anteroposterior çapı (FVAPd) ve intervertebral foramen yüksekliğini (FIVh) ölçerek anatomik değişiklikleri değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntemler: Bu retrospektif çalışmaya LSTV tanısı almış 274 hasta dahil edilmiştir. Tüm MR görüntüleri 1.5T MR cihazı ve 32 kanallı lumbar coil ile elde edilmiştir. Morfolojik veriler oluşturan LSTV'nin varlığı, koronal ve sagittal reformat görüntülerden tespit edilerek lumbalizasyon veya sakralizasyon olarak sınıflandırılmıştır. Morfometrik veriler (IVDh, FIVh ve FVAPd), hem yumuşak doku hem de kemik pencere ayarları kullanılarak aksiyal, sagittal ve koronal düzlemlerden elde edilmiştir.
Bulgular: Hastaların ortalama yaşı 41.6±13.0 yıl olup, çoğunluğu (%55.8) kadındır. LSTV vakalarının büyük çoğunluğu (%96.4) lumbalizasyon, geri kalan vakalar ise sakralizasyon şeklinde görülmüştür. Genel olarak ortalama FVAPd 11.2±2.4 mm, ortalama IVDh 9.1±1.8 mm, ortalama FIVh sağda 18.8±2.4 mm ve solda 19.1±2.4 mm olarak bulunmuştur. IVDh düzeyleri yaş grupları arasında tutarlılık gösterirken, FVAPd değerleri cinsiyet açısından benzerdi. 40 yaş ve altındaki hastalarda FVAPd ve FIVh düzeyleri daha yüksek, erkek hastalarda ise kadınlara kıyasla IVDh ve FIVh düzeyleri daha yüksek bulunmuştur.
Sonuç: LSTV'nin morfometrik özellikleri yaş ve cinsiyete göre farklılık gösterebilir. Bu faktörlerin dikkate alınarak LSTV'nin anatomik varyasyonlarının doğru bir şekilde tanımlanması, uygun tedavi ve yönetim stratejilerinin belirlenmesinde önemli bir rol oynayabilir.

Keywords

lumbalizasyon, lomber kanal, lumbosakral geçiş vertebrası, sakralizasyon, sakral kanal

Symptomatic and morphometric analysis of lumbosacral transitional vertebrae: assessments by age and gender

Abstract

Aim: Lumbosakral transitional vertebrae (LSTV) are anatomical variations where a vertebra exhibits characteristics of both lumbar and sacral vertebrae. This study aims to assess anatomical changes in LSTV patients by measuring intervertebral disc height (IVDh), vertebral foramen anteroposterior diameter (FVAPd), and intervertebral foramen height (FIVh), with consideration of age and gender differences.
Material and Methods: This retrospective study included 274 patients diagnosed with LSTV. All MRI images were acquired with a 1.5T MRI machine and a 32-channel lumbar coil. The presence of LSTV, forming the morphological data, was identified from coronal and sagittal reformat images and was classified as either lumbarization or sacralization. Morphometric data (IVDh, FIVh and FVAPd) were acquired from axial, sagittal, and coronal planes using both soft tissue and bone window settings.
Results: The mean patient age was 41.6±13.0 years, with a female majority (55.8%). LSTV was predominantly lumbarization (96.4%), with sacralization in the remaining cases. The overall mean FVAPd was 11.2±2.4 mm, mean IVDh was 9.1±1.8 mm, and mean FIVh was 18.8±2.4 mm on the right and 19.1±2.4 mm on the left. IVDh levels were consistent across age groups, while FVAPd values were similar between genders. Patients aged 40 and under had higher FVAPd and FIVh levels, and male patients had higher IVDh and FIVh levels compared to females.
Conclusions: The morphometric characteristics of LSTV may vary according to age and gender. Considering these factors in accurately identifying the anatomical variations of LSTV may play a significant role in determining appropriate treatment and management strategies.

Keywords

lumbalisation, lumbar canal, lumbasacral transitional vertebra, sacralisation, sacral canal

Ethical Statement

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Binali Yıldırım University Clinical Research Ethics Committee (Approval Date: 30.03.2023, Number: 2023-07/4).

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