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Thesis Title
MORPHOMETRIC STUDY OF DRIED
HUMAN TYPICAL AND ATYPICAL
LUMBER VERTBRAE IN GUJARAT
REGION.
(For M.D. Anatomy)
(Branch III)
Study Period: 2.5 Years (Jul)
Dr. Chitrarth Jigishkumar Modi
1st Year Resident,
Anatomy Department,
B. J. Medical College,
Ahmedabad – 16.
Contact no: 8980620009
PG Teacher:
Dr. Sucheta Vinayakrao Patil
Professor and Head,
Anatomy Department,
B. J. Medical College.
MORPHOMETRIC STUDY OF DRIED HUMAN TYPICAL
AND ATYPICAL LUMBER VERTBRAE IN GUJARAT
REGION.
INTRODUCTION:
The vertebral column is a curved linkage of individual bones called vertebrae.
The adult vertebral column usually consists of 33 vertebral segments. Each presacral
segment (except the first two cervical) is separated from its neighbor segment by a
fibro-cartilaginous intervertebral disc. The usual number of vertebrae is 7 cervical, 12
thoracic, 5 lumbar, 5 sacral and 4 coccygeal, this total is subject to frequent variability,
and there have been reports of variation between 32 and 35 bones.8
In Latin language, ‘lumbus’ means ‘lion’; hence lumbar vertebrae are compared
to a lion. As they possess high degree of flexibility and offer stability to the vertebral
column.4, 6 They transmit the weight of the upper half of the body to the lower limb.
The lumbar vertebrae labeled in descending order as L1 to L5 respectively, out of
which the upper four are considered as typical lumbar vertebrae and the fifth is
considered as an atypical lumbar vertebra.5, 7
The lumbar vertebrae are distinguished from others by their large size and the
absence of costal facets and transverse foramina. The typical lumber vertebrae are
characterized by transversely wider body, large triangular shaped vertebral foramen,
thin and long transverse process and thick spinous process. The superior articular
processes face posteromedially, with a rough mammillary process on their posterior
borders. The inferior articular processes face anterolaterally. A small accessory process
marks the posteroinferior aspect of the root of each transverse process.8
The fifth lumbar vertebrae is the only atypical lumbar vertebrae differs from
others by having massive body, its anterior surface is more extensive than posterior
surface, transverse processes encroach on the sides of the body from the junctions of
pedicles and lamina. Pedicle of fifth lumbar vertebrae helps in forward slide of L5 over
S1. As it is contributing to the lumbosacral angle.2
Vertebral morphology and morphometry are influenced externally by
mechanical (dynamic force) and environmental factors; And internally by genetic,
metabolic and hormonal factors.
Clinically, the findings from a morphometric analysis of lumbar vertebrae have
profound implications. They enhance surgical accuracy, reduce the risk of iatrogenic
injury, and contribute to the development of region-specific spinal implants such as
pedicle screw. Understanding these morphometric variations is also beneficial in
forensic anthropology for identification purposes and in radiology for interpreting
diagnostic imaging accurately.
STUDY HYPOTHESIS:
There are significant and measurable morphometric variations in the anatomical
parameters of typical and atypical lumbar vertebrae. That have direct clinical
implications in various pathologies notably lumbar spinal stenosis, fractures,
malignancies, inflammatory disorders, infections, abnormal curvatures such as lumbar
lordosis, scoliosis, spondylolisthesis, involve the vertebrae.
AIMS AND OBJECTIVES:
Aim: The aim of the present study is to conduct a comprehensive morphometric
examination and comparison of the typical (L1-L4) and atypical lumbar (L5) vertebrae
in the population of the Gujarat region.
Objectives: The specific objectives are as follows:
• To measure various dimensions of the vertebral body notably height,
anteroposterior, and transverse diameter.
• To measure the various diameters vertebral foramen: anteroposterior and
transverse diameters.
• To measure the height, width, length and inter-pedicular distance of the
pedicles on both sides of the lumbar vertebrae.
• To measure the height, length and thickness of the lamina on both sides of the
lumbar vertebrae.
• To measure the height and width of the superior and inferior articular
process on both sides of the lumbar vertebrae.
• To measure the height, length and width of the transverse process on both
sides of the lumbar vertebrae.
• To measure the length, width and thickness of the spinous process on both
sides of the lumbar vertebrae.
• To compare the morphometric data between the typical (L1-L4) and atypical
lumbar (L5) vertebrae and assess intra-specimen and inter-specimen variations.
• To provide a morphometric reference database for anatomists, radiologists,
neurosurgeons, and orthopedic surgeons for safe and effective clinical practice
involving the cervical spine.
MATERIALS AND METHOD:
Study Setting
The study will be carried out in Department of Anatomy, B. J. Medical College,
Ahmedabad.
Study Period
The study period will be from July 2025 – July 2026.
Study Design
This is a descriptive, observational morphometric study focused on typical (L1-L4) and
atypical (L5) lumber vertebrae to assess anatomical dimensions and their clinical
correlations.
Sample Size
The present study will be conducted on 200 dried adult human lumber vertebrae (150
typical L1 - L4 and 50 atypical - L5) of unknown age and unknown sex, obtained from
the Department of Anatomy, B. J. Medical College, Ahmedabad.
Inclusion Criteria
• Intact and undamaged Dry typical and atypical lumbar vertebrae obtain from
adult human cadavers.
• Vertebrae with clearly identifiable anatomical landmarks.
• Specimens sourced ethically from anatomy departments with documented
provenance.
Exclusion Criteria
• Vertebrae with congenital anomalies or evidence of trauma, deformity, or
surgical alteration.
• Vertebrae from individuals below 18 years of age.
• Specimens with deformity, erosion, or missing parts or pathological changes
affecting key morphometric landmarks.
Instruments
Following instruments will be used in present study to measures various parameters:
• Digital Vernier Caliper with a precision of 0.01mm
• Divider
• Measuring Scale
• Black Marker Pen
Data Collection
The following parameters will be measured in dry adult human lumbar vertebrae by
use of above mentioned instruments:
1. Anterior and Posterior height of body: Vertical distance between superior and
inferior surface will be measured at anterior and posterior border.
2. Anteroposterior diameter of body at superior and inferior surface: Midline
distance will be measured between anterior and posterior border of the body
over superior and inferior surfaces.
3. Transverse diameter of body at superior and inferior surface: Maximum
transverse diameter of body will be measured at superior and inferior surfaces.
4. Anteroposterior and Transverse diameter of vertebral canal: The
anteroposterior diameter of vertebral canal will be measured at the midline. And
the transverse diameter will be measured between two lateral margins of
vertebral foramen.
5. Height, width, and length of pedicle of both sides: Height will be measured as
a maximum vertical distance between superior and inferior border of pedicle at
its midpoint of right and left side. Width will be measured as a maximum
distance between medial and lateral surfaces of pedicle measured at right angle
to long axis of pedicle of right and left side. And length will be measured
between the distance from the point where the pedicle contacts the body to the
point of junction of transverse process and superior articular process.
6. Inter-pedicular distance: Maximum distance between the right medial surfaces
and left medial surface of the pedicles of the same vertebrae will be measured as
the inter-pedicular diameter.
7. Height, length, and thickness of lamina of both sides: The vertical distance
between the midpoints of superior and inferior borders of the lamina will be
measured as the height of the lamina. The distance between the midpoints of
medial and lateral ends of the lamina will be measured as the width of the
lamina. The thickness will be measured at the central points of anterior and
posterior surfaces of the lamina.
8. Height, width and length of transverse process of both sides: The distance
from the lateral end of superior aspect of vertebral foramen to the tip of the
transverse process will be measured as the length of the transverse process. The
distance between the midpoints of medial and lateral surface of transverse
process will be measured as the width of the transverse process. The vertical
distance between the midpoints of superior and inferior borders of the transverse
process will be measured as the height of the transverse process.
9. Height, length, and thickness of Spinous process of both sides: The distance
between the most anterior and most posterior points on the superior border of the
spinous process will be measured as the length of the spinous process. The
vertical distance between the most posterior points on the superior and inferior
borders of the spinous process will be measured as the height of spinous process.
The distance between the central points of the two lateral surfaces of spinous
process was measured as the width of the spinous process.
10. Height and width of superior articular process of both sides: The distance
between superior and inferior border will be measured as height, while the
distance between medial and lateral border will be measured as width of superior
articular process.
11. Height and width of inferior articular process of both sides: The distance
between superior and inferior border will be measured as height, while the
distance between medial and lateral border will be measured as width of inferior
articular process.
12. Distance between two superior articular processes: will be measured between
the midpoints of both superior articular process of the same vertebrae.
13. Distance between two inferior articular processes: will be measured between
the midpoints of both inferior articular process of the same vertebrae.
14. Distance between superior and inferior articular process of both side: will
be measured between the midpoints of superior and inferior articular processes
of the same vertebrae.
15. Distance between two mammillary processes: will be measured between tip of
the right and left mammillary process of the same vertebrae.
16. Distance between two accessory processes: will be measured between tip of
the right and left accessory process of the same vertebrae.
Data Analysis
• The recorded data will be entered and calculated into Microsoft Excel 2016 and
IBM SPSS Statistics 25 software (Statistical Package for The Social Sciences).
• Identification of normally distributed numerical data will be done.
• Data will be compared using the ANOVO test and Pearson Correlation
Coefficient.
• Presentation of Results: The analyzed data will be presented using tables, bar
charts and pie charts for visual representation of categorical variables.
REVIEW OF LITERATURE
In 1987, Berry JL et al1 conducted morphometric study on 240 dry human vertebrae
obtain from museum of Cleveland, Ohio. They were measured height of body at
anterior and posterior border 27.14 ± 1.9 mm and 25.26 ± 4.22 mm respectively. They
were measured transverse diameter of body at superior and inferior surface 49.42 ± 4.5
mm and 52.26 ± 4.22 mm respectively. While the anteroposterior diameter of body at
superior and inferior surface was 33.82 ± 3.5 mm and 34.00 ± 3.26 mm respectively.
They were measured anteroposterior and transverse diameter of vertebral canal 16.56 ±
2.1 mm and 23.16 ± 2.2 mm.
In 1992, Wang TM et al12 compared morphometric data between 450 Chinese and
179 Indian dry human lumbar vertebrae. They were measured height of body 25.02 ±
0.24 mm in Chinese and 24.84 ± 0.34 mm in India. They were measured
anteroposterior diameter of vertebral canal 8.07 ± 0.19 mm (L1) to 5.04 ± 0.15 mm
(L5) in Chinese and 7.56 ± 0.20 mm (L1) to 4.54 ± 0.18 mm (L5) in Indian. They were
measured transverse diameter of body 30.29 ± 0.29 mm (L1) to 34.23 ± 0.33 mm (L1)
in Chinese and 29.62 ± 0.33 mm (L1) to 33.16 ± 0.47 mm (L5) in Indian. They were
measured anteroposterior diameter of body 38.33 ± 0.56 mm (L1) to 44.51 ± 0.39 mm
(L1) in Chinese and 37.56 ± 0.55 mm (L1) to 41.75 ± 0.81 mm (L5) in Indian. The
inter-pedicular diameter was 26.38 ± 0.21 mm in Chinese and 28.02 ± 0.37 mm in
India.
In 1994, Kim NH et al3 conducted morphometric study on 73 dry human vertebrae in
Korean population. They were measured widest width of pedicle 18.4 mm (L5) and
lowest width of pedicle 4.1 mm (L4). The widest and narrowest height of pedicle was
measured 15.4 mm in L1 and 13.7 mm in L4 respectively.
In 2006, Varol TU et al11 conducted morphometric study on 275 dry human vertebrae
and 40 CT scan images. They were measured anteroposterior diameter of vertebral
canal 15.92 ± 2.1 mm (Typical) and 16.46 ± 2.36 mm (Atypical) in dry vertebrae,
while 17.15 ± 2.23 mm (Typical) and 18.61 ± 2.05 mm (Atypical) in CT scan. They
were measured inter-pedicular diameter 19.76 ± 1.3 mm (Typical) and 21.46 ± 3.09
mm (Atypical) in dry vertebrae, while 20.4 ± 2.47 mm (Typical) and 24.01 ± 2.39 mm
(Atypical) in CT scan. They measured distance between superior articular process in
typical and atypical dry vertebrae 18.38 ± 3.70 mm and 14.30 ± 3.35 mm respectively,
while distance between inferior articular process in typical and atypical dry vertebrae
12.96 ± 4.49 mm and 13.66 ± 4.81 mm respectively. They measured distance between
superior and inferior articular process in right and left side of typical dry vertebrae 4.24
± 1.08 mm and 3.96 ± 1.01 mm respectively, while in right and left side of atypical dry
vertebrae 3.00 ± 0.83 mm and 2.54 ± 0.71 mm respectively.
In 2015, Tiwari A et al10 conducted on 45 dry typical lumbar vertebrae in Madhya
Pradesh. They were measured width of pedicle 9.48 ± 3.35 mm in right side and 9.55 ±
3.57 mm in left side. They were measured height of pedicle 13.44 ± 1.53 mm in right
side and 13.06 ± 1.53 mm in left side.
In 2020, Yılmaz S et al13 conducted morphometric study on 123 dry human vertebrae..
They were measured height of body at anterior and posterior border 25.79 mm and
26.08 mm respectively. They were measured transverse diameter of body at superior
and inferior surface 45.62 mm and 47.93 mm respectively. While the anteroposterior
diameter of body at superior and inferior surface was 31.99 mm and 32.45 mm
respectively. They were measured anteroposterior and transverse diameter of vertebral
canal 17.95 mm and 24.04 mm. They measured distance between two superior articular
process 30.02 mm and two inferior articular process 21.03 mm. They measured
distance between two accessory process 74.99 mm and two mammillary process 34.59
mm.
In 2023, Shalini R eT al7 conducted morphometric study on 200 dry human vertebrae
(100 typical and 100 atypical). They were measured height of body at anterior and
posterior border 24.74± 1.34 mm and 25.69 ± 1.42 mm respectively in typical
vertebrae, while 24.05 ± 1.43 mm and 24.84 ± 1.68 mm respectively in atypical
vertebrae. They were measured anteroposterior and transverse diameter of body 27.61
± 1.78 mm and 41.65 ± 1.65 mm respectively in typical vertebrae, while 30.69 ± 2.23
mm and 45.66 ± 2.45 mm respectively in atypical vertebrae. They were measured
anteroposterior and transverse diameter of vertebral canal 20.08 ± 1.59 mm and 25.21
± 2.71 mm respectively in typical vertebrae, while 20.35 ± 1.23 mm and 24.76 ± 2.18
mm respectively in atypical vertebrae. They were measured length, height and width of
transverse process 13.12 ± 1.34 mm, 8.74 ± 1.33 mm and 5.01 ± 1.35 mm respectively
in typical vertebrae, while 12.87 ± 1.91 mm, 8.81 ± 1.51 mm and 4.14 ± 0.85 mm
respectively in atypical vertebrae. They were measured height, and length of lamina
19.75 ± 2.18 mm, and 12.43 ± 1.76 mm respectively in typical vertebrae, while 23.18 ±
1.77 mm, and 12.43 ± 1.19 mm respectively in atypical vertebrae.
In 2023, Subramanian S et al9 conducted on 50 dry lumbar vertebrae. They were
measured width of pedicle 6.61 ± 0.85 mm in L1 to 14.52 ± 1.65 mm in L5. They were
measured height of pedicle 22.76 ± 1.96 mm in L1 to 8.35 ± 0.85 mm in L5. They
were measured inter-pedicular diameter 19.51± 1.56 mm in L1 to 23.21 ± 1.91 mm in
L5.
In 2024, Rao NS et al6 conducted morphometric study on 47 dry human vertebrae.
They were measured height of body 25.6 ± 3.8 mm. They were measured transverse
diameter of 44.00 ± 6.2 mm. While the anteroposterior diameter of body at superior
and inferior surface was 31.1 ± 5.4 mm and 31.6 ± 3.1 mm respectively. They were
measured anteroposterior and transverse diameter of vertebral canal 15.2 ± 3.9 mm and
23.6 ± 3.6 mm. They were measured length, height and thickness of lamina 12.7 ± 3.2
mm, 21.8 ± 4.8 mm and 7.3 ± 2.2 mm respectively in right side, while 12.3 ± 3.2 mm,
22.4 ± 4.8 mm and 7.3 ± 2.2 mm respectively in left side. They were measured height,
and width of superior articular process 13.5 ± 3.4 mm, and 12.8 ± 2.8 mm respectively
in right side, while 13.7 ± 3.2 mm, and 12.7 ± 2.9 mm respectively in left side. They
were measured height, and width of inferior articular process 12.8 ± 2.8 mm, and 14.8
± 2.8 mm respectively in right side, while 12.4 ± 2.9 mm, and 14.6 ± 3.2 mm
respectively in left side.
BIBLIOGRAPHY
1. Berry JL, Moran JM, Berg WS, Steffee AD. A morphometric study of human
lumbar and selected thoracic vertebrae. Spine. 1987 May 1;12(4):362-7.
2. Datta AK. Essentials of Human Anatomy: Part 1.In: Lumbar vertebrae. 8 Calcutta.
Current Books International. 2008;143-44.
3. Kim NH, Lee HM, Chung IH, Kim HJ, Kim SJ. Morphometric study of the pedicles
of thoracic and lumbar vertebrae in Koreans. Spine. 1994 Jun 1;19(12):1390-4.
4. Megala S, Paventhan B, Subbulakshmi G. Clinical Anatomy of The Lumbar Spine:
A Morphometric And Radiological Approach In A South Indian Population:
Observational Study. International Journal of Pharmaceutical And Clinical
Research. 2024 Jun 26;16(7):1379–84.
5. Radel B. Lumbar Transverse Process Length as A Landmark For Lumbar Spine
Enumeration In The Setting Of Lumbosacral Transitional Vertebrae. Johannesburg:
University of Johannesburg. 2023 Aug.
6. Rao NS, Kavitha T, Devi KV. Morphometric Assessment of Adult Human Lumbar
Vertebrae. European Journal of Cardiovascular Medicine. 2024 Jan 1;14(1).
7. Shalini R, Pushpa K, Mangaiyarkkarasi P, Thiagarajan S. A Morphometric Study of
Typical and Atypical Lumbar Vertebrae in South Indian Population. Acta Medica
International. 2023 Jan 1;10(1):14-20.
8. Standring S, Ellis H, Wigley C. Gray's Anatomy: The Anatomical Basis of Clinical
Practice. 41 Ed. Edinburgh New York: Elsevier Churchill Livingstone, 2016:14726.
9. Subramanian S. Morphometric Study Of The Lumbar Vertebrae Pedicle In Dry
Human Bones In South Indian Population. Asian J Pharm Clin Res.
2023;16(12):109-11.
10. Tiwari A, Pandey S, Naik DC. A study of height and width of typical lumbar
pedicles in relation to mechanical load. Int J Med Sci Public Health. 2015 Feb
1;4:275.
11. Varol TU, Iyem C, Cezayirli EN, Erturk M, Kayalioglu G, Hayretdag C.
Comparative morphometry of the lower lumbar vertebrae: osteometry in dry bones
and computed tomography images of patients with and without low back pain.
Journal of International Medical Research. 2006 May;34(3):316-30.
12. Wang TM, Shih C. Morphometric variations of the lumbar vertebrae between
Chinese and Indian adults. Cells Tissues Organs. 1992 Jul 16;144(1):23-9.
13. Yılmaz S, Ünalmış D, Tokpınar A. Morphometric measurements on lumbal
vertebras and its importance. Journal of US-China Medical Science. 2020;17:60-6.
CASE RECORD PROFORMA
MORPHOMETRIC STUDY OF DRIED HUMAN TYPICAL AND
ATYPICAL LUMBER VERTBRAE IN GUJARAT REGION.
Study Period: 2.5 Years [November 2023 – May 2026]
Table 1: Measurement of vertebral body (in mm)
Sr no. /
Parameters
Height of body
Anterior
border
Posterior
border
Anteroposterior
diameter
Superior
Inferior
surface
surface
Transverse diameter
Superior
surface
Inferior
surface
1
2
Table 2: Measurement of vertebral canal (in mm)
Sr no. /
Parameters
Anteroposterior
diameter
Transverse
diameter
Interpedicular
diameter
1
2
Table 3: Measurement of pedicles (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Width
Right side Left side
Length
Right side Left side
Table 4: Measurement of lamina (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Length
Right side Left side
Thickness
Right side Left side
Table 5: Measurement of transverse process (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Width
Right side Left side
Length
Right side Left side
Table 6: Measurement of spinous process (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Length
Right side Left side
Thickness
Right side Left side
Table 7: Measurement of superior articular process (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Width
Right side Left side
Table 8: Measurement of inferior articular process (in mm)
Sr no. /
Parameters
1
2
Height
Right side Left side
Width
Right side Left side
Table 9: Distance between various processes (in mm)
Sr no. /
Parameters
1
2
Two superior
articular
processes
Two inferior
articular
processes
Two
accessory
processes
Two
mammillary
processes
Superior and
inferior
articular
processes
Rt
Lt