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Localizing the L5 Vertebra Using Nerve Morphology on MRI: An Accurate and Reliable Technique

Overview of attention for article published in American Journal of Neuroradiology, August 2017
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  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#10 of 2,899)
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (98th percentile)

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82 tweeters
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2 Facebook pages
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1 Google+ user

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16 Mendeley
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Title
Localizing the L5 Vertebra Using Nerve Morphology on MRI: An Accurate and Reliable Technique
Published in
American Journal of Neuroradiology, August 2017
DOI 10.3174/ajnr.a5311
Pubmed ID
Authors

M.E. Peckham, T.A. Hutchins, S.E. Stilwill, M.K. Mills, B.J. Morrissey, E.A.R. Joiner, R.K. Sanders, G.J. Stoddard, L.M. Shah

Abstract

Multiple methods have been used to determine the lumbar vertebral level on MR imaging, particularly when full spine imaging is unavailable. Because postmortem studies show 95% accuracy of numbering the lumbar vertebral bodies by counting the lumbar nerve roots, attention to lumbar nerve morphology on axial MR imaging can provide numbering clues. We sought to determine whether the L5 vertebra could be accurately localized by using nerve morphology on MR imaging. One hundred eight cases with full spine MR imaging were numbered from the C2 vertebral body to the sacrum with note of thoracolumbar and lumbosacral transitional states. The origin level of the L5 nerve and iliolumbar ligament were documented in all cases. The reference standard of numbering by full spine imaging was compared with the nerve morphology numbering method. Five blinded raters evaluated all lumbar MRIs with nerve morphology technique twice. Prevalence and bias-adjusted κ were used to measure interrater and intrarater reliability. The L5 nerve arose from the 24th presacral vertebra (L5) in 106/108 cases. The percentage of perfect agreement with the reference standard was 98.1% (95% CI, 93.5%-99.8%), which was preserved in transitional and numeric variation states. The iliolumbar ligament localization method showed 83.3% (95% CI, 74.9%-89.8%) perfect agreement with the reference standard. Inter- and intrarater reliability when using the nerve morphology method was strong. The exiting L5 nerve can allow accurate localization of the corresponding vertebrae, which is essential for preprocedure planning in cases where full spine imaging is not available. This neuroanatomic method displays higher agreement with the reference standard compared with previously described methods, with strong inter- and intrarater reliability.

Twitter Demographics

The data shown below were collected from the profiles of 82 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 4 25%
Professor 3 19%
Student > Bachelor 3 19%
Researcher 2 13%
Unspecified 2 13%
Other 2 13%
Readers by discipline Count As %
Medicine and Dentistry 13 81%
Unspecified 2 13%
Nursing and Health Professions 1 6%

Attention Score in Context

This research output has an Altmetric Attention Score of 61. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 July 2018.
All research outputs
#214,709
of 11,667,520 outputs
Outputs from American Journal of Neuroradiology
#10
of 2,899 outputs
Outputs of similar age
#11,475
of 266,832 outputs
Outputs of similar age from American Journal of Neuroradiology
#1
of 84 outputs
Altmetric has tracked 11,667,520 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,899 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,832 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 84 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 98% of its contemporaries.