Transition vortex
A transition vortex (Syn .: assimilation fluidized , shift vortex ; engl transitional vertebra, assimilated vertebra.) Is a congenital variation at the boundaries of the spinal segments that to be found in about 35% of the population. Transitional vortices have completely or partially adopted the shapes and properties of the adjacent vortex regions.
Typical examples are the sacralization of the 5th lumbar vertebra (lumbar vertebra) - in this case the 5th lumbar vertebra is fused with the first sacral vertebra without a functional disc - or the lumbarization of the 1st sacral vertebra , here there is an intervertebral disc between the first and second sacral vertebra , so that the first cross vertebra is functionally to be regarded as an additional (sixth) lumbar vertebra.
A distinction is made between full and partial (partial) transition vertebrae, depending on the strength of the assimilation. In the case of partial transitional vertebrae, there are also forms in which one side is assimilated while the other side is unchanged, which can then lead to asymmetrical movement patterns in this section of the spine.
Transitional vertebrae are particularly clinically relevant because they are associated with an increased risk that the wrong spine segments will be operated on if the height is mixed up, or that injections will be administered at the wrong height. They are also associated with a higher risk of spondylosis of the overlying intervertebral disc, while the connection with increased back pain cannot be reliably established. At least symmetrical transitional disorders, in which both sides of the vertebra are equally affected, tend not to increase the risk of back pain, while asymmetrical transitional vertebrae can be associated with increased back pain.
Classification of the lumbosacral transition vertebra
According to Castellvi, this most common transitional disorder can be classified into four forms, depending on the shape of the transverse processes and their connection to the sacrum, the higher the degree of which is associated with a stronger sacralization and the lower the degree of the stronger lumbarization of the transitional vertebra, but this has no correlation with possible complaints . Grades 1–3 are also subdivided depending on whether the findings are unilateral (A) or bilateral (B):
- The transverse process is enlarged and broadened on one side (1A) or on both sides (1B), without any articulated or bony connection to the sacrum
- The transverse process is enlarged on one side (2A) or on both sides (2B) and has an articulated connection to the sacrum
- The transverse process is enlarged on one side (3A) or on both sides (3B) and fused with the sacrum via a bone connection
- Both transverse processes are enlarged, one is bony connected to the sacrum and the other is articulated.
Individual evidence
- ^ EA Zimmer, Marianne Zimmer-Brossy: Textbook of X-ray diagnostic setting technology. Springer, Berlin, Heidelberg 2013, ISBN 978-3-662-08334-5 , p. 570, doi : 10.1007 / 978-3-662-08333-8 .
- ↑ Roche Lexicon Medicine (4th ed.)
- ↑ M. Farshad, A. Aichmair, AP Hughes, RJ Herzog, NA Farshad-Amacker: A reliable measurement for identifying a lumbosacral transitional vertebra with a solid bony bridge on a single-slice midsagittal MRI or plain lateral radiograph . The Bone & Joint Journal 2013, Volume 95-B, Issue 11, November 2013, pages 1533-1537; DOI: 10.1302 / 0301-620X.95B11.32331
- ^ AE Castellvi, LA Goldstein, DP Chan: Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects . Spine 1984; Volume 9, pages 493-495
literature
- Koehler, Zimmer: Limits of the normal and the beginnings of the pathological in the X-ray image of the skeleton . Georg Thieme Verlag Stuttgart, New York, 1989, ISBN 3-13-111723-0