Radiographic evaluation of intercristal line in North Cyprus population

Abstract

Background: The intercristal line (ICL) is a beneficial guideline for lumbar procedures but it can differ according to the age, gender, and ethnicity of the patient. The aim of this study was to measure the lumbar vertebrae level crossed by the ICL in a North Cyprus population. Methods: In this study, anteroposterior lumbosacral radiographs of 350 patients were evaluated retrospectively. The ICL was drawn as it connects the most superior points of the iliac crests on anteroposterior lumbosacral radiographs. Patients were grouped by age (18 to 40 yr and 41-65 yr) and gender. Both L4 and L5 vertebrae were divided into three equal parts with horizontal lines. Each part and the L4-L5 disc space were numbered ascending from 1 to 7 from the upper border of L4 vertebrae to the lower border of L5 vertebrae. The range of lumbar vertebrae levels crossed by the ICL was recorded and compared between different age and gender groups. Results: A total of 296 anteroposterior lumbosacral radiographs were included in the study. One hundred and sixty-nine (57%) were men and 127 (43%) were women. The ICL level was found between the lower third of L4 and upper third of L5 in most spines (80%). The ICL level distribution was found between the upper third of L4 and middle third of L5 in all patients. It was observed that the ICL level was lower in younger people and in women. Conclusions: In 80% of a North Cyprus population, the ICL level was found to be between the lower third of L4 and upper third of L5, and depended on age and gender.