Lumbosacral Vertebral Angles can Predict Lumbosacral Transitional Vertebrae on Routine Sagittal MRI

Objectives: We aimed to measure lumbosacral vertebral angles in routine lumbar sagittal MRIs and assess their association with lumbosacral transitional vertebrae (LSTV).Methods: We recruited ۲۲۰ patients referring to our hospital for routine lumbar MRI during ۲۰۲۰-۲۰۲۱. All the participants were subject to routine sagittal lumbar MRI, whole spine localizer scan, and coronal MRI to numerate lumbar vertebrae. Five vertebral angles (A, B, C, D, and delta) and dehydration in L۴-L۵ and L۵-S۱ discs were assessed in sagittal MRI scans. Data were analyzed using SPSS ۲۶.Results: Out of ۲۲۰ participants (mean age: ۴۴.۲۹ ± ۱۴.۱۴ years), ۳۶ (۱۶.۳۶%) were diagnosed with LSTV. Among those diagnosed with LSTV, L۵-S۱ dehydration was less frequently observed compared to other participants (P < ۰.۰۰۱). Multivariate regression showed that dehydrated L۴-L۵ disc, non-dehydrated L۵-S۱ disc, increased A-angle, and decreased D-angle can independently predict LSTV. The median A-angle was significantly larger in LSTV patients than in non-LSTV participants (P = ۰.۰۳۸), while the medians of C-angle, D-angle, and delta-angle were significantly smaller in the LSTV group (P < ۰.۰۵). A C-angle ≤ ۳۵.۵˚ could diagnose LSTV with sensitivity and specificity of ۷۲.۲% and ۵۷.۶%, respectively. A delta angle ≤ ۸.۵˚ could diagnose type ۲ LSTV with ۹۲.۳% sensitivity and ۸۷.۹% specificity.Conclusion: Measuring lumbosacral vertebral angles, especially delta-angle, in routine sagittal MRI can potentially alert physicians of a likely LSTV diagnosis.        Level of evidence: III

کلیدواژه ها:

Angle ، Diagnosis ، Lumbosacral Transitional Vertebrae ، magnetic resonance imaging