Reply to Letter to the Editor: “Quantitative measurements at the lumbosacral junction are more reliable parameters for identifying and numbering lumbosacral transitional vertebrae”
by Haitao Yang (frankyang119@126.com)
Quantitative measurements at the lumbosacral junction are more reliable parameters for identifying and numbering lumbosacral transitional vertebraeDear Editor-in-Chief,
We thank Dr. Mahato for the interest in our article “Quantitative measurements at the lumbosacral junction are more reliable parameters for identifying and numbering lumbosacral transitional vertebrae” [1]. Dr. Mahato has raised many important points regarding the assessment of LSTV-affected lumbar spine from a more systematic perspective and we totally agree with Dr. Mahato.
Compared with the normal anatomy, the alterations of morphology and segmental lordosis in the lumbosacral region are part of the imaging features of LSTVs in our study, which may simply reflect adaptations to the altered mechanism of biomechanics [2]. However the exact biological mechanism and clinical impacts are still not fully understood. As Dr. Mahato pointed out, based on dynamic imaging of LSTV-affected lumbar spine, further assessment of LSTV-induced alterations in the lumbosacral kinematics in different functional positions, including flexion, extension, lateral bending, axial rotation and different weight-bearing positions [3, 4], may help to better understand the effects of LSTVs on the spine and even the lumbo-pelvic complex [5-7]. Future studies combining the lumbosacral statics and kinematics of the anatomic characteristics of LSTVs also need to be investigated. The statics and kinematics aspects, for example, include the range of motion (ROM) and segmental lordosis of the lumbosacral segment, the axial loading and the shear force from different directions at the vertebrae, the intervertebral discs, the facets, the posterior ligament complex and paravertebral muscle, the morphology and balance of pelvic and lumbo-pelvic complex. Such studies may be helpful to detect the functional effects of LSTVs and guide the course of clinical treatment in the cases of LSTV-affected lumbar spine, which may differ from the normal population.
Finally, we really appreciate the insightful comments provided by Dr. Mahato, which have offered a more comprehensive perspective for our further studies.