Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine.

IF 1.7 Q2 SURGERY
David Shin, Kai Nguyen, Easton Small, Trevor Case, Mikayla Kricfalusi, Alexander Bouterse, Andrew Cabrera, Ethan Purnell, Wheddy Laguerre, Jacob Razzouk, Omar Ramos, Olumide Danisa, Wayne Cheng
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Abstract

Background: This study aimed to determine whether the iliac crests are truly at the level of L4 to L5, accounting for patient demographic and anthropometric characteristics.

Methods: We measured the umbilicus and iliac crests relative to the lumbar spine using computed tomography of patients without spinal pathology, accounting for the influences of patient height, weight, body mass index (BMI), sex, race, and ethnicity.

Results: A total of 834 patients (391 men and 443 women) were reviewed. The location of the umbilicus relative to the lumbar spine demonstrated a unimodal distribution pattern clustered at L4, while the iliac crests were most frequently located from L4 to L5. Iliac crests were located above the L4 to L5 disc space 26.5% of the time. Iliac crests were located at the L4 to L5 disc space 29.8% of the time. No correlations were observed between the umbilicus and iliac crests with patient height, weight, or BMI. There was no difference in the location of the umbilicus with respect to patient sex, race, and ethnicity. The locations of the iliac crests were cephalad in women compared with men and in Hispanics compared with African American, Caucasian, and Asian patients.

Conclusions: The iliac crests were located above the level of the L4 to L5 disc space approximately 26% of the time. The umbilicus is most frequently at the level of the L4 vertebral body. Patient height, weight, and BMI do not influence the location of the umbilicus or the iliac crests relative to the lumbar spine. Patient sex and ethnicity influence the location of the iliac crests but not the umbilicus relative to the lumbar spine.

Clinical relevance: Modern neurosurgical techniques require clearance of the iliac crests during anterior and anterolateral approaches. Understanding the level of the iliac crests is crucial in planning for transpsoas fusion approaches.

Level of evidence: 2:

脐带和髂嵴是否真正位于 L4 至 L5 水平?基于计算机断层扫描的腰椎前部表面解剖学研究。
背景:本研究旨在确定髂嵴是否真正位于 L4 至 L5 水平:本研究旨在确定髂嵴是否真正位于L4至L5水平,同时考虑到患者的人口统计学和人体测量学特征:我们使用计算机断层扫描测量了无脊柱病变患者的脐部和髂嵴相对于腰椎的位置,并考虑了患者身高、体重、体重指数(BMI)、性别、种族和民族的影响:共对 834 名患者(391 名男性和 443 名女性)进行了复查。脐部相对于腰椎的位置呈现单峰分布模式,集中在L4,而髂嵴最常位于L4至L5。髂嵴位于L4至L5椎间盘间隙上方的比例为26.5%。髂嵴位于 L4 至 L5 椎间盘间隙的比例为 29.8%。脐嵴和髂嵴与患者的身高、体重或体重指数之间没有相关性。脐的位置与患者的性别、种族和民族没有差异。与男性患者相比,女性患者的髂嵴位置在头侧;与非裔美国人、高加索人和亚裔患者相比,西班牙裔患者的髂嵴位置在头侧:结论:髂嵴位于 L4 至 L5 椎间盘间隙水平以上的比例约为 26%。脐部最常位于 L4 椎体水平。患者的身高、体重和体重指数不会影响脐部或髂嵴相对于腰椎的位置。患者的性别和种族会影响髂嵴的位置,但不会影响脐部相对于腰椎的位置:现代神经外科技术要求在前方和前外侧入路时清除髂嵴。了解髂嵴的水平对于规划经腰椎融合术至关重要:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
162
期刊介绍: The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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