Getting on Your Nerves: Spine Numbering Utilizing Lumbosacral Plexus Anatomy

Multiple anatomic markers have been used to number the lumbar spine when complete spine imaging is unavailable. In this review, we discussed the current methods of spine numbering and reviewed a recently validated neuroanatomic method of spine numbering that uses the MR imaging of lumbosacral plexus anatomy for localization. This method is promising, not only in its accuracy in localizing the L5 vertebral body, but also in its ability to aid preoperative planning for the interventionalist/surgeon by anatomically delineating the exiting nerves. With a solid foundation in lumbosacral plexus anatomy, this method can be easily applied and communicated by the radiologist.

Learning Objective: To review various imaging approaches for spine numbering; to discuss using nerve morphology on conventional MR imaging for spine numbering; and to explain the importance of spine numbering in radiology reports.