vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2020-17-4-401-408vestim-706Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEВрожденные аномалии пояснично-крестцового отдела позвоночникаCongenital anomalies of the lumbosacral spineКабакС. Л.KabakS. L.

Кабак Сергей Львович – доктор медицинских наук, профессор, заведующий кафедрой

пр. Дзержинского, 83, 220116, г. Минск

Sergei L. Kabak – D. Sc. (Med.), Professor, Head of the Department

83, Dzerzhynski Ave., 220116, Minsk

kabakmorph@gmail.comЗаточнаяВ. В.ZatochnayaV. V.

Заточная Валентина Владимировна – старший преподаватель

пр. Дзержинского, 83, 220116, г. Минск

Valentina V. Zatochnaya – Senior Lecturer

83, Dzerzhynski Ave., 220116, Minsk

v.zatochnaya@gmail.comЖижко-МихасевичН. О.Zhizhko-MikhasevichN. O.

Жижко-Михасевич Наталья Олеговна – врач-рентгенолог

ул.Кижеватова, 60/4, 220024, г. Минск

Natalya O. Zhizhko-Mikhasevich – Radiologist

60/4, Kizhevatov Str., 220024, Minsk

nataliamikhasevich@rambler.ruБелорусский государственный медицинский университетBelarusian State Medical UniversityРеспубликанский научно-практический центр травматологии и ортопедииRepublican Scientific and Practical Centre for Traumatology and Orthopedics202005122020174401408Copyright © Кабак С.Л., Заточная В.В., Жижко-Михасевич Н.О., 20202020Кабак С.Л., Заточная В.В., Жижко-Михасевич Н.О.Kabak S.L., Zatochnaya V.V., Zhizhko-Mikhasevich N.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/706

Цель исследования – провести сравнительный анализ строения переходного пояснично-крестцового позвонка, выявляемого с помощью компьютерной томографии (КТ) и на анатомических препаратах, а также обсудить возможные патогенетические механизмы формирования этой аномалии развития. В статье представлено описание переходного пояснично-крестцового позвонка, в том числе 6 случаев сакрализации L5 и 3 случая люмбализации S1. Формирование переходного пояснично-крестцового позвонка детерминировано генетически. Большинство типов подобной аномалии развития удается выявить только с помощью КТ. Сакрализация последнего поясничного позвонка повторяет процесс слияния крестцовых позвонков в единую кость. Напротив, нарушение конкресценции поперечнореберных отростков закладки первых крестцовых позвонков как нормального процесса его морфогенеза имеет следствием люмбализацию S1.

The aim of the study is to compare the structure of the lumbosacral transitional vertebra, which were detected by computed tomography (CT) and identified on dried human sacral, and to discuss possible pathogenetic mechanisms of this congenital malformation. The article presents 9 cases of lumbosacral transitional vertebra, including 6 cases of L5 sacralization and 3 cases of S1 lumbarization. The formation of the transitional lumbosacral vertebra is genetically determined. All types of such developmental anomaly can be detected only on CT. L5 sacralization repeats the process of fusion of the sacral vertebra into a single bone. A lack of the costotransverse bars of the first sacral vertebrae fusion results in the S1 lumbarization.

крестецпереходный пояснично-крестцовый позвоноксакрализациялюмбализацияsacrumlumbosacral transitional vertebrasacralizationlumbarizationReferencesMalformed vertebrae: a clinical and imaging review / A. Chaturvedi [et al.] // Insights into Imaging. – 2018. – Vol. 9, N 3. – P. 343–355. https://doi.org/10.1007/s13244-018-0598-1Chaturvedi A., Klionsky N. B., Nadarajah U., Chaturvedi A., Meyers S. P. Malformed vertebrae: a clinical and imaging review. Insights into Imaging, 2018, vol. 9, no. 3, pp. 343–355. https://doi.org/10.1007/s13244-018-0598-1Esses, S. E. Surgical anatomy and operative approaches to the sacrum / S. E. Esses, D. J. Botsford // The adult spine: principles and practice. – Philadelphia, 1997. – Vol. 2. – P. 2329–2341.Esses S. E., Botsford D. J. Surgical anatomy and operative approaches to the sacrum. The adult spine: Principles and practice. Philadelphia, 1997, vol. 2, pp. 2329–2341.Cheng, J. S. Anatomy of the sacrum / J. S. Cheng, J. K. Song // Neurosurg. Focus. – 2003. – Vol. 15, N 2. – P. 1–4. https://doi.org/10.3171/foc.2003.15.2.3Cheng J. S., Song J. K. Anatomy of the sacrum. Neurosurgical Focus, 2003, vol. 15, no. 2, pp. 1–4. https://doi.org/10.3171/foc.2003.15.2.3Mahato, N. K. Transitional female sacrum: dimensions, alterations in dorsal pelvic structure, and potential obstetric implications / N. K. Mahato // Oman Med. J. – 2018. – Vol. 33, N 1. – P. 22–28. https://doi.org/10.5001/omj.2018.05Mahato N. K. Transitional female sacrum: dimensions, alterations in dorsal pelvic structure, and potential obstetric implications. Oman Medical Journal, 2018, vol. 33, no. 1, p. 22–28. https://doi.org/10.5001/omj.2018.05Khairnar, K. B. Sacralization of lumbar vertebra / K. B. Khairnar, M. B. Rajale // Indian J. Basic Appl. Med. Res. – 2013. – Vol. 6, N 2. – P. 510–514.Khairnar K. B., Rajale M. B. Sacralization of lumbar vertebra. Indian Journal of Basic and Applied Medical Research, 2013, vol. 6, no. 2, pp. 510–514.Shetty, A. S. Sacralization of fifth lumbar vertebra – a case report / A. S. Shetty, R. Jetti // Austin J. Anatomy. – 2017. – Vol. 4, N 2. – P. 1066–1067. https://doi.org/10.26420/austinjanat.2017.1066Shetty A. S., Jetti R. Sacralization of fifth lumbar vertebra – a case report. Austin Journal of Anatomy, 2017, vol. 4, no. 2, pp. 1066–1067. https://doi.org/10.26420/austinjanat.2017.1066Nikumbh, R. D. Morphological study of sacralisation of fifth lumbar vertebra and its clinical relevance / R. D. Nikumbh, A. N. Wanjari, D. B. Nikumbh // Indian J. Anat. – 2017. – Vol. 6, N 2. – P. 119–124. https://doi.org/10.21088/ija.2320.0022.6217.5Nikumbh R. D., Wanjari A. N., Nikumbh D. B. Morphological study of sacralisation of fifth lumbar vertebra and its clinical relevance. Indian Journal of Anatomy, 2017, vol. 6, no. 2, pp. 119–124. https://doi.org/10.21088/ija.2320.0022.6217.5Bhasin, R. Sacralization of lumbar vertebrae-its anatomical, embryological and clinical perspective / R. Bhasin, S. Hamid, S. Raina // Global J. Res. Analys. – 2018. – Vol. 7, N 9. – P. 28–30.Bhasin R., Hamid S., Raina S. Sacralization of lumbar vertebrae-its anatomical, embryological and clinical perspective. Global Journal for Research Analysis, 2018, vol. 7, no. 9, pp. 28–30.Mahato, N. K. Complete sacralization of L5 vertebrae: traits, dimensions, and load bearing in the involved sacra / N. K. Mahato // Spine J. – 2010. – Vol. 10, N 7. – P. 610–615. https://doi.org/10.1016/j.spinee.2010.04.012Mahato N. K. Complete sacralization of L5 vertebrae: traits, dimensions, and load bearing in the involved sacra. Spine Journal, 2010, vol. 10, no. 7, pp. 610–615. https://doi.org/10.1016/j.spinee.2010.04.012Tague, R. G. Sacralization is not associated with elongated cervical costal process and cervical rib / R. G. Tague // Clin. Anat. – 2011. – Vol. 24, N 2. – P. 209–217. https://doi.org/10.1002/ca.21087Tague R. G. Sacralization is not associated with elongated cervical costal process and cervical rib. Clinical Anatomy, 2011, vol. 24, no. 2, pp. 209–217. https://doi.org/10.1002/ca.21087Castellvi, A. E. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects / A. E. Castellvi, L. A. Goldstein, D. P. Chan // Spine. – 1984. – Vol. 9, N 5. – P. 493–495. https://doi.org/10.1097/00007632-198407000-00014Castellvi A. E., Goldstein L. A., Chan D. P. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine, 1984, vol. 9, no. 5, pp. 493–495. https://doi.org/10.1097/00007632-198407000-00014Wazir, S. Sacralisation of lumbar vertebrae / S. Wazir // Int. J. Anat. Res. – 2014. – Vol. 2, N 2. – P. 386–389.Wazir S. Sacralisation of lumbar vertebrae. International Journal of Anatomy and Research, 2014, vol. 2, no. 2, pp. 386–389.Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification / J. V. Patel [et al.] // Int. J. Res. Orthoped. – 2016. – Vol. 3, N 1. – P. 116. https://doi.org/10.18203/issn.2455-4510.intjresorthop20164835Patel J. V., Mehta C. M., Patil N. G., Sehgal S. R. Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification. International Journal of Research in Orthopedics, 2016, vol. 3, no. 1, p. 116. https://doi.org/10.18203/issn.2455-4510.intjresorthop20164835Retrospective cohort study of the prevalence of lumbosacral transitional vertebra in a wide and well-represented population / D. Uçar [et al.] // Arthritis. – 2013. – Vol. 2013. – P. 1–5. https://doi.org/10.1155/2013/461425Uçar D., Uçar B. Y., Coşar Y., Emrem K., Gümüşsuyu G., Mutlu S., Mutlu B., Çaçan M. A., Mertsoy Y., Gümüş H. Retrospective cohort study of the prevalence of lumbosacral transitional vertebra in a wide and well-represented population. Arthritis, 2013, vol. 2013, pp. 1–5. https://doi.org/10.1155/2013/461425Sharma, V. A. Oesteogenic study of lumbosacral transitional vertebra in central India region / V. A. Sharma, D. K. Sharma, C. K. Shukla // J. Anat. Soc. India. – 2011. – Vol. 60, N 2. – P. 212–217. https://doi.org/10.1016/s0003-2778(11)80030-4Sharma V. A., Sharma D. K., Shukla C. K. Oesteogenic study of lumbosacral transitional vertebra in central India region. Journal of Anatomical Society of India, 2011, vol. 60, no. 2, pp. 212–217. https://doi.org/10.1016/s0003-2778(11)80030-4Krishnamurthy, A. Study on incidence of sacralisation of fifth lumbar vertebra in South Indian population / A. Krishnamurthy, M. Adibatti // Ital. J. Anat. Embryol. – 2016. – Vol. 121, N 1. – P. 60–65.Krishnamurthy A., Adibatti M. Study on incidence of sacralisation of fifth lumbar vertebra in South Indian population. Italian Journal of Anatomy and Embryology, 2016, vol. 121, no. 1, pp. 60–65.Mallo, M. Hox genes and regional patterning of the vertebrate body plan / M. Mallo, D. M. Wellik, J. Deschamps // Develop. Biol. – 2010. – Vol. 344, N 1. – P. 7–15. https://doi.org/10.1016/j.ydbio.2010.04.024Mallo M., Wellik D. M., Deschamps J. Hox genes and regional patterning of the vertebrate body plan. Developmental Biology, 2010, vol. 344, no. 1, pp. 7–15. https://doi.org/10.1016/j.ydbio.2010.04.024Wellik, D. M. Hox10 and Hox11 genes are required to globally pattern the mammalian skeleton / D. M. Wellik, M. R. Capecchi // Science. – 2003. – Vol. 301, N 5631. – P. 363–367. https://doi.org/10.1126/science.1085672Wellik D. M., Capecchi M. R. Hox10 and Hox11 genes are required to globally pattern the mammalian skeleton. Science, 2003, vol. 301, no. 5631, pp. 363–367. https://doi.org/10.1126/science.1085672Hox genes specify vertebral types in the presomitic mesoderm / M. Carapuço [et al.] // Genes & Development. – 2005. – Vol. 19, N 18. – P. 2116–2121. https://doi.org/10.1101/gad.338705Carapuço M., Nóvoa A., Bobola N., Mallo M. Hox genes specify vertebral types in the presomitic mesoderm. Genes and Development, 2005, vol. 19, no. 18, pp. 2116–2121. https://doi.org/10.1101/gad.338705Salsabili, N. Development of the human sacroiliac joint / N. Salsabili, D. A. Hogg // Clin. Anat. – 1991. – Vol. 4, N 2. – P. 99–108. https://doi.org/10.1002/ca.980040204Salsabili N., Hogg D. A. Development of the human sacroiliac joint. Clinical Anatomy, 1991, vol. 4, no. 2, pp. 99–108. https://doi.org/10.1002/ca.980040204Steele, D. G. The anatomy and biology of the human skeleton / D. G. Steele, C. A. Bramblett. – Texas A&M Univ. Press, 1988. – 304 p.Steele D. G., Bramblett C. A. The anatomy and biology of the human skeleton. Texas A&M University Press, 1988. 304 p.Coalson, R. E. Musculoskeletal system / R. E. Coalson, J. J. Tomasek // Embryology. – N. Y., 1992. – P. 46–56.Coalson R. E., Tomasek J. J. Musculoskeletal System. Embryology. New York, 1992, pp. 46–56.Bakkum, B. W. Development of the spine and spinal cord / B. W. Bakkum, W. E. Bachop // Clinical Anatomy of the Spine, Spinal Cord, and Ans / ed. : G. D. Cramer, S. A. Darby. – St. Louis, 2014. – P. 541–565.Bakkum B. W., Bachop W. E. Development of the spine and spinal cord. Clinical Anatomy of the Spine, Spinal Cord, and Ans. St. Louis, 2014, pp. 541–565.Jain, A. Sacral-alar-iliac fixation in pediatric deformity: radiographic outcomes and complications / A. Jain, K. M. Kebaish, P. D. Sponseller // Spine Deformity. – 2016. – Vol. 4, N 3. – P. 225–229. https://doi.org/10.1016/j.jspd.2015.11.005Jain A., Kebaish K. M., Sponseller P. D. Sacral-alar-iliac fixation in pediatric deformity: radiographic outcomes and complications. Spine Deformity, 2016, vol. 4, no. 3, pp. 225–229. https://doi.org/10.1016/j.jspd.2015.11.005Макарова, А. В. Аномалии развития позвоночного столба [Электронный ресурс] / А. В. Макарова, А. Г. Сероух // Студенческий научный форум : VII Междунар. студент. эл. науч. конф., 15 февр.–31 марта 2015 г. – Режим доступа : http://www.scienceforum.ru/2015/898/11185. – Дата доступа : 04.10.2020.Makarova A. V., Seroukh A. G. Anomalies of development of vertebral colums. Studencheskii nauchnyi forum : VII Mezhdunarodnaya studencheskaya elektronnaya nauchnaya konferentsiya, 15 fevralya–31 marta 2015 goda [Student scientific forum: VII International student electronic scientific conference, February 15–March 31, 2015]. Available at: http://www.scienceforum.ru/2015/898/11185 (accessed 04.10.2020) (in Russian).

The authors declare that there are no conflicts of interest present.