关键词: 腰骶移行椎, 腰骶神经根, 误诊, 脊柱全长影像, 支配区变化

Abstract:

Objective　 To detect the distribution variation patterns of lumbar nerve roots in patients with lumbosacral transitional vertebrae (LSTV).　 Methods　From May 2008 to March 2010, lumbosacral disc herniation was confirmed by CT and/or MRI scanning on LSTV patients verified by conventional whole spinal radiographs. For those SZ cases, physical examination was performed to detect distribution variation of lumbosacral nerves, including false LSTV cases of C-I sacralization(SZ) or C -IIIB lumbarization(LZ). 　Results　12 SZ and 12 LZ cases were enrolled in the study. Among SZ cases, 5 C-IIIB, 3 non-squaring well-configured and 1 IIIA cases existed the disturbances caused by lumbar nerve compression(s) resembled those by the same and /or one level distal nerve(s) in non-LSTV ones. The disturbances caused by lumbar nerve compressions in 3 C-IIB ones resembled that in non-LSTV ones. Among 12 LZ ones, the distributions caused by lumbosacral nerve compression(s) in 10 total-lumbarization ones resembled that by the same and/or the lower proximal nerve(s) in non-LSTV ones, and the disturbances caused by S1~2 nerve root in one total-lumbarization resembled that by L4~S1 nerve root compression in non-LSTV one. The disturbance caused by lumbar nerve compressions in one case of C-IV LZ resembled that in non-LSTV one.　Conclusions　In patients with sacralization, lumbosacral nerve roots tend to act as the usual function of nerves at the same level and/or lower level in non-LSTV ones, especially in those with decreased mobile segment ones. In patients with lumbarization, the lumbosacral nerve roots tend to act as the usual function of nerves at the same level and/or upper level in non-LSTV ones, especially with increased mobile ones.

Key words: Lumbosacral transitional vertebrae, Lumbosacral nerve root, Misdiagnosis, Whole spinal radiographs, Distribution variation