Imaging review proposes a sequence for identifying transitional spinal vertebrae
The authors favor X-rays for numbering vertebrae and CT for confirming this anatomical variation, but the abstract does not report diagnostic accuracy estimates.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
This review examined imaging methods for identifying lumbosacral transitional vertebrae and avoiding errors in spinal-level numbering. The authors describe CT as the preferred diagnostic standard and propose a sequence beginning with plain X-rays, followed by CT when the variation is suspected. Their proposed approach is not accompanied by reported validation results or patient-outcome data in the abstract.
The abstract gives no numerical sensitivity or specificity estimates, patient characteristics or evidence that the proposed sequence reduces identification errors. It therefore cannot establish how well the pathway performs in clinical practice.
Why vertebral identification matters
The authors focused on recognizing this variation in the lower spine and assigning vertebral levels correctly. Their intended applications included procedures performed through the skin and biomechanical measurements, where identifying the relevant level matters.
What the proposed pathway includes
Beyond initial X-rays and confirmatory CT, the proposed approach reserves MRI for selected cases and includes assessment of bone shape and classification. The abstract describes these steps as the authors' diagnostic methodology.
The original publication
Radiologic Insights: Diagnosing Lumbosacral Transitional Vertebrae. Systematic Review of the Literature.
Andrade-Andrade P, Acevedo-González JC
Pain Pract · 2026
- PubMed ID
- 41800527
- Record checked
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