Prominent caudal shift of the lumbar plexus roots in spines with 18 thoracolumbar vertebrae.

IF 1.2 4区医学 Q3 ANATOMY & MORPHOLOGY

Surgical and Radiologic Anatomy Pub Date : 2023-10-01 Epub Date: 2023-07-31 DOI:10.1007/s00276-023-03210-y

Tomokazu Kawashima, Fumi Sato

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引用次数: 0

Abstract

Purpose: It remains unclear whether concomitant changes in the thoracolumbar (TL) vertebrae and lumbar plexus roots seen in experimental embryology are present in humans with different vertebral formulas, particularly in humans with 18 TL vertebrae. We thus investigated the human lumbar plexus root changes occurring in spines with an additional TL vertebra (18TL).

Methods: The lumbosacral plexus was macroscopically dissected in TL anomaly cases found in 161 computed tomography examinations. TL anomalies were distinguished as simple abnormalities in total TL count and abnormal TL trade-offs, i.e., exchanges between the last thoracic and first lumbar vertebrae, and were analyzed separately.

Results: One additional TL vertebra (7C_18TL_5S) was observed in 4/159 cases (2.5%), excluding cases with cervical and sacral abnormalities. Different from the unclear shifts of nerve roots in cases with 16TL and 17TL trade-offs, the 18TL trade-off tended to involve a caudal shift at the cranial limit, without event change at the caudal limit. In addition, only one nerve segment shift was reconfirmed with a change in two vertebral segments from 16 to 18 TL vertebrae.

Conclusions: We revealed that concomitant changes in the lumbar plexus roots and vertebrae in humans with 18TL vertebrae may become more pronounced than those in humans with 16 or 17TL vertebrae, by approaching the typical mammalian TL formula (19TL). This study showed that the TL formula can be used to estimate changes in the lumbar plexus roots, which may assist in the planning of nerve-sparing spinal and pelvic surgery.

Abstract Image

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18节胸腰段脊椎中腰丛根的显著尾部移位。

目的：目前尚不清楚在实验胚胎学中观察到的胸腰段（TL）椎骨和腰丛根的伴随变化是否存在于具有不同椎骨配方的人类中，特别是在具有18节TL椎骨的人类中。因此，我们研究了附加TL椎骨（18TL）的脊柱中发生的人类腰丛根的变化。方法：对161例CT检查中发现的TL异常病例，行腰骶丛宏观解剖。TL异常被区分为总TL计数的简单异常和异常TL权衡，即最后一节胸椎和第一节腰椎之间的交换，并分别进行分析。结果：159例患者中有4例（2.5%）额外观察到一个TL椎骨（7C_18TL_5S），不包括颈部和骶骨异常的病例。与16TL和17TL权衡病例中神经根的不清楚移位不同，18TL权衡往往涉及头端的尾部移位，而尾端没有事件变化。此外，只有一个神经节段移位被再次确认，两个椎骨节段从16节TL变为18节TL。结论：我们发现，通过接近典型的哺乳动物TL公式（19TL），患有18TL椎骨的人类的腰丛根和椎骨的伴随变化可能比患有16或17TL椎骨的人更明显。这项研究表明，TL公式可用于估计腰丛根的变化，这可能有助于规划保留神经的脊柱和骨盆手术。

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

Surgical and Radiologic Anatomy ANATOMY & MORPHOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.70

自引率

14.30%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.