Professional Documents
Culture Documents
VERTEBRAE
Type of sacralization.
A: Complete sacralization.
Lumbar AP radiograph shows the
complete fusion of the L5
transverse process with the S1
vertebra. The absence of a 12th
rib is also apparent.
B: Incomplete sacralization.
C: Mixed type.
The right transverse
process of L5 is the
complete type, but the
left side is an incomplete
type. Hypoplasia of the
12th rib is also
demonstrated.
Nicholson et al described a
decreased height on
radiographs of the disk
between a lumbar transitional
segment and the sacrum
compared with the normal
disk height between L5 and
S1.
Similarly, it has been observed
that when a lumbarized S1 is
present, the disk space
between S1 and S2 is larger
than the rudimentary disk that
is most often seen in spines
without transition.
Numbering Technique
With a sagittal MR localizer, the
vertebrae may be counted in a
caudad direction from C2 rather
than cephalad from L5.
Another technique used to correctly
number an LSTV is locating the
iliolumbar ligaments, because they
reliably arise from the L5
transverse processes. The
iliolumbar ligament functions to
restrain flexion, extension, axial
rotation, and lateral bending of L5
on S1. It is seen as a low-signalintensity structure on both axial
T1- and T2-weighted MR images as
a single or double band extending
from the transverse process of L5
to the posteromedial iliac crest.
Bertolotti Syndrome
Mid-sagittal T2-weighted
fast spin-echo image of
the lumbar spine
illustrates the angle
measurements which
were performed in the
study. A-angle was
defined by a line parallel
to the superior surface of
the sacrum and a line
perpendicular to the axis
of the scan table.
B-angle was defined by a
line parallel to the
superior endplate of L3
vertebra and a line
parallel to the superior
surface of the sacrum.
T2-weighted images of the lumbar spine. A: The mid-sagittal T2weighted image of the lumbar spine exhibits increased A-angle
(49.38) and B-angle (53.04); B: Corresponding axial fast spin-echo
image in this 42-year-old female subject with transitional lumbosacral
anatomy demonstrates bilateral pseudoarthrosis of the transitional
vertebra with the sacral ala (arrowheads).
THANK U