Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Spinal Enumeration by Morphologic Analysis of Spinal Variants: Comparison to Counting in a Cranial-To-Caudal Manner

  • Yun, Sam (Department of Radiology, Kosin University Gospel Hospital) ;
  • Park, Sekyoung (Department of Radiology, Kosin University Gospel Hospital) ;
  • Park, Jung Gu (Department of Radiology, Kosin University Gospel Hospital) ;
  • Huh, Jin Do (Department of Radiology, Kosin University Gospel Hospital) ;
  • Shin, Young Gyung (Department of Radiology, Kosin University Gospel Hospital) ;
  • Yun, Jong Hyouk (Department of Radiology, Kosin University Gospel Hospital)
  • Received : 2017.11.15
  • Accepted : 2018.05.06
  • Published : 2018.12.01
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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 (${\kappa}$ 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.

Keywords

References

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