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Surgical and Radiologic Anatomy

Erschienen in:

31.07.2023 | Original Article

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

verfasst von: Tomokazu Kawashima, Fumi Sato

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 10/2023

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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.

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Titel: Prominent caudal shift of the lumbar plexus roots in spines with 18 thoracolumbar vertebrae
verfasst von: Tomokazu Kawashima
Fumi Sato
Publikationsdatum: 31.07.2023
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 10/2023
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-023-03210-y

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