Evidence map›Paper›PMID 41003722›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

A vertebral shape-based classification for labeling the thoracolumbar junction on CT imaging.

David Schinz, Hendrik Möller, Constanze Ramschütz, Paul Platzek, Robert Graf, Anjany Sekuboyina, Malek El Husseini, Matthias Stefan May, Michael Uder, Claus Zimmer and 1 more

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In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Letter to the editor concerning "Automated extraction of vertebral bone mineral density from imaging with various scan parameters: a cadaver study with correlation to quantitative computed tomography" by C. Ramschütz et al. (Eur spine J [2025]; doi: 10.1007/s00586-025-09146-8).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

David SchinzUniversitätsklinikum Erlangen, Erlangen, Germany. david.schinz@uk-erlangen.de.
Hendrik MöllerTechnical University of Munich, Munich, Germany.
Constanze RamschützTechnical University of Munich, Munich, Germany.
Paul PlatzekTechnical University of Munich, Munich, Germany.
Robert GrafTechnical University of Munich, Munich, Germany.
Anjany SekuboyinaTechnical University of Munich, Munich, Germany.
Malek El HusseiniTechnical University of Munich, Munich, Germany.
Matthias Stefan MayUniversitätsklinikum Erlangen, Erlangen, Germany.
Michael UderUniversitätsklinikum Erlangen, Erlangen, Germany.
Claus ZimmerTechnical University of Munich, Munich, Germany.
Jan Stefan KirschkeTechnical University of Munich, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe correct identification of the thoracolumbar junction is mandatory for labeling of the lumbar spine, particularly if visualized incompletely. The current state-of-the-art relies on a continuous counting-based (CCBC), a rib-length-based (RLBC), or rib-based classification (RBC) of the spine enumeration. However, the CCBC and RBC often lead to inconsistent labels depending on the visualized spine segments.

methodsIn this retrospective study, three classifications for assessing the thoracolumbar junction were evaluated in CT scans from 2005 to 2018, covering the complete thoracolumbar spine: (1) CCBC, (2) RLBC/RBC, and (3) a vertebra-shape-based classification (VSBC). The classifications were compared regarding consistent labels depending on the visualized spine segments, agreement with nerve morphology, and inter-rater reliability.

resultsCT-imaging data from 1,242 subjects (mean age, 63 years ± 12; 771 women) were included. The VSBC led to more consistent labels than all other classifications. Only the VSBC perfectly complied with the nerve morphology (VSBC, 100%; RBC, 97.2%, RLBC, 96.3%; CCBC, 92.6%). The VSBC had slightly superior inter-rater reliability than the RBC (0.61 vs. 0.59).

conclusionThe VSBC performs more reliably and consistently than other classifications in labeling the thoracolumbar junction, even for anatomical variants or incompletely visualized spines. Compared with rib-based classifications, the VSBC demonstrated modest but clear advantages in consistency and agreement with nerve morphology.

Indexed as

Lumbar VertebraeThoracic VertebraeTomography, X-Ray ComputedAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesComputed tomographySpineSpine aberrationThoracolumbar junctionThoracolumbar transitional vertebraeVertebra labeling

Identifiers

PMID41003722

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.