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mamakaren
15th June 2005, 09:57 PM
There is a new service at our hospital where patients (and parents of minor patients) can access their own medical records online. I just signed up for this yesterday and was able to access the narrative description of Martha's spinal x-rays.

This is what it said:

"a thoracolumbar levoscoliosis with the apex at T12"

and also

"There appears to be a transitional vertebral body at lumbosacral junction."

Anyone??

What is a transitional vertebral body and where is the lumbosacral junction??


Thanks!

Karen

jfkimberly
15th June 2005, 10:14 PM
According to my quick Google check, transitional vertebral bodies is partial fusing of the bone of two adjacent vertebrae. The lumbosacral junction would be where the lumbar spine connects to the sacrum. See image:
http://www.stjohnsmercy.org/healthinfo/test/images/ei_0397.gif

So my guess is the notes say that L5 appears to be fused to the sacrum.

As for the thoracolumbar levoscoliosis with apex at T12:
-thoracolumbar: curve that involves the thoracic and lumbar spine
-levoscoliosis: scoliosis where the convex side is on the left
-apex at T12: The midpoint of the curve, sort of. Hmm... how do you define "apex of a curve"? Anyway, the curve centers around T12.

mamakaren
15th June 2005, 10:21 PM
Wow. thanks. So would her curve be a right thoracic or left thoracic then? From the neck down it first curves right and then left.. . .

jfkimberly
15th June 2005, 10:28 PM
The vertebrae are numbered from top to bottom. There are 12 thoracic vertebrae (T1 to T12, going from top to bottom), and the apex of the curve is at T12... so the middle of her curve is centered around the lowest thoracic vertebrae, and the curve would extend above (thoraco-) and below (-lumbar) the apex. That's why it's called a thoracolumbar curve... both regions are involved in it.

mamakaren
15th June 2005, 10:31 PM
Okay, that makes sense. Again, thank you. Since it starts out going to the right then the thoracic portion of the curve is right. I read that most curves that start going left from the top are not idiopathic but most likely due to a pathological process so I just want to make sure her curve is not of that type.

titch
15th June 2005, 10:40 PM
Infantile curves are more likely to be left curves even when idiopathic, and I've read that there is evidence that a left facing primary curve is more common in left handed people, so while it's a factor that suggest doing more tests just to be sure, I don't think it's as cut and dried as some of the information suggests.

mamakaren
15th June 2005, 10:46 PM
Thanks Titch. It's good to be here among people with so much more expertise than I have.

At this point I am mentally tallying reasons to be as optimistic as possible. But I know that a right-thoracic curve is no guarantee of anything. . .

Jonny
16th June 2005, 12:06 AM
I fit in with everything: my thoracic curve goes to the right, as most do, and my lumbar curve (that was larger) goes to the left, and I'm left handed :-D I'm an odd case that my anterior surgery was on the left but my thoracoplasty was on the right.

I think you could say that the 'apex' of a curve is the most laterally displaced vertebra. I think the apex of normal lordosis is L3/4 (OK, most anteriorly displaced), and the apex of normal kyphosis is T7 (most posteriorly displaced).

jfkimberly
16th June 2005, 12:13 AM
Ooh, I like that. "Most laterally displaced vertebra" describes it nicely. Thanks, Jonny.