{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:02:05Z","timestamp":1789646525602,"version":"4.0.0"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background: The thoracolumbar junction (TLJ) includes the T11\u2013L2 vertebral segments. It is a pivotal biomechanical transition zone between the rigid thoracic spine and the more mobile lumbar spine. Accurate morphometric data from this region are crucial for understanding human axial biomechanics and supporting forensic investigations. Objective: This study was designed to establish a normative multi-detector computed tomography (MDCT) database of the human thoracolumbar junction (T11\u2013L2) in an adult population. Specifically, the primary objectives were to quantify normal vertebral and pedicle dimensions and to investigate the prevalence of congenital rib anomalies. The ultimate clinical goal is to translate these anatomical metrics into practical guidelines for spinal surgery and tools for forensic sex estimation. Materials and Methods: A retrospective analysis of 517 adults (277 men, 240 women) who received thoracic CT for various clinical indications was conducted. Morphometric parameters, including anterior, middle, and posterior vertebral heights; transverse and sagittal pedicle diameters; pedicle length; and transverse pedicle angle, were systematically measured. Costal variations, including hypoplastic and supernumerary ribs, were carefully recorded. Results: Vertebral and pedicle linear dimensions were generally larger in men than in women. The mean transverse pedicle diameter (TPD) increased progressively from T11 to L2. Significant sexual dimorphism in TPD was observed at the T11, L1, and L2 levels (p &lt; 0.05), whereas both transverse (p = 0.168) and sagittal (p = 0.251) pedicle dimensions remained statistically comparable between sexes exclusively at the T12 transitional segment. The transverse pedicle angle (TPA) showed a consistent, increasing medial trajectory from T11 (~21\u00b0) to L2 (~28\u00b0) in both sexes, with no significant sex-based difference (p &gt; 0.05). The overall prevalence of congenital rib variations was 18.57%. The most frequent structural anomaly was 12th-rib hypoplasia. Conclusions: This study provides a detailed morphometric baseline for the TLJ in an adult cohort (n = 517) of Turkish adults. The findings show that while absolute pedicle size and volumetric mass are influenced by sexually dimorphic physical geometry, the spatial trajectory and angulation of the pedicles (TPA) are determined by biomechanical principles that are independent of sex. In addition, pronounced sexual dimorphism and a high prevalence of unique costal variations were observed. These factors provide valuable biological markers that serve as reliable radiological fingerprints for forensic anthropologists who estimate sex from skeletal remains and identify unknown individuals.<\/jats:p>","DOI":"10.3390\/tomography12080109","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:45:26Z","timestamp":1785239126000},"page":"109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MDCT Morphometry of the Thoracolumbar Junction in a Turkish Cohort: Surgical, Radiological, and Forensic Implications"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4987-9581","authenticated-orcid":false,"given":"Lale","family":"Duman","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Health Sciences, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir 35120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Esra","family":"Sirzai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir 35120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref_1","first-page":"e948632","article-title":"Computed tomography-based morphometric analysis of the thoracolumbar junction in the young Turkish population","volume":"30","author":"Yerli","year":"2024","journal-title":"Med. Sci. Monit."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.14744\/tjtes.2025.60930","article-title":"Open versus percutaneous short-segment posterior instrumentation in thoracolumbar junction burst fractures","volume":"31","author":"Bilgin","year":"2025","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_3","first-page":"485","article-title":"Common Vertebral Fracture Level After the 2023 Turkey Earthquake: Thoracolumbar Junction\u2014Due to Hyper-Flexed and Fixed Posture\u2014At Triangle of Life Areas","volume":"34","author":"Alpergin","year":"2024","journal-title":"Turk. Neurosurg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/00007632-198703000-00012","article-title":"Analysis of the morphometric characteristics of the thoracic and lumbar pedicles","volume":"12","author":"Zindrick","year":"1987","journal-title":"Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.14744\/tjtes.2025.09155","article-title":"Assessing the impact of radiological measurement methods on forensic medical reports in traumatic vertebral compression fractures","volume":"31","author":"Sak","year":"2025","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"433","DOI":"10.5603\/FM.a2017.0005","article-title":"Morphometric analysis of the lumbar vertebrae in the Turkish population using three-dimensional computed tomography: Correlation with sex, age, and height","volume":"76","year":"2017","journal-title":"Folia Morphol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1097\/00007632-199406000-00014","article-title":"Morphometric study of the pedicles of thoracic and lumbar vertebrae in Koreans","volume":"19","author":"Kim","year":"1994","journal-title":"Spine"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wu, S., Liu, S., Ling, M., Huang, M., Liu, Z., and Duan, X. (2024). A novel method to evaluate the transverse pedicle angles of the lower lumbar vertebrae using digital radiography. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0295196"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5603\/FM.a2023.0006","article-title":"Evaluation of congenital rib anomalies with multi-detector computed tomography in the Turkish population","volume":"83","author":"Oner","year":"2024","journal-title":"Folia Morphol."},{"key":"ref_10","first-page":"e16597","article-title":"Virtual Morphometry of the First Lumbar Vertebrae for Estimation of Sex Using Computed Tomography Data in the Turkish Population","volume":"13","author":"Bozdag","year":"2021","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s41935-021-00238-2","article-title":"Sex estimation using the human vertebra: A systematic review","volume":"11","author":"Rohmani","year":"2021","journal-title":"Egypt. J. Forensic Sci."},{"key":"ref_12","first-page":"199","article-title":"Morphometric analysis of thoracolumbar junction pedicle diameters in different adult age groups","volume":"25","author":"Gergin","year":"2014","journal-title":"J. Turk. Spinal Surg."},{"key":"ref_13","first-page":"97","article-title":"Morphometric study of lumbar vertebra pedicles","volume":"26","author":"Gergin","year":"2015","journal-title":"J. Turk. Spinal Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20756","DOI":"10.1038\/s41598-025-05091-0","article-title":"AI-based CT assessment of 3117 vertebrae reveals significant sex-specific vertebral height differences","volume":"15","author":"Palm","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s00276-024-03509-4","article-title":"The morphology of the lumbar vertebrae: A systematic review with meta-analysis of 1481 individuals with implications for spine surgery","volume":"47","author":"Bonczar","year":"2024","journal-title":"Surg. Radiol. Anat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/00007632-198904000-00004","article-title":"Anatomic analysis of pedicle cortical and cancellous diameter as related to screw size","volume":"14","author":"Misenhimer","year":"1989","journal-title":"Spine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6089","DOI":"10.16965\/ijar.2018.414","article-title":"Thoracic pedicle morphometry study on cadaver and CT scan with its clinical applications","volume":"7","author":"Shetty","year":"2019","journal-title":"Int. J. Anat. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/BRS.0000000000001738","article-title":"Accuracy and Safety of Pedicle Screw Placement in Adolescent Idiopathic Scoliosis Patients: A Review of 2020 Screws Using Computed Tomography Assessment","volume":"42","author":"Kwan","year":"2017","journal-title":"Spine"},{"key":"ref_19","first-page":"44","article-title":"Functional outcomes and pedicle screw accuracy in dorsal and lumbar spine fractures: A prospective comparative study of C-arm versus O-arm navigation","volume":"15","author":"Gupta","year":"2026","journal-title":"Indian J. Neurosurg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"715","DOI":"10.4103\/0028-3886.59465","article-title":"\u201cFree-hand\u201d technique for thoracolumbar pedicle screw instrumentation: Critical appraisal of current \u201cstate-of-art\u201d","volume":"57","author":"Mattei","year":"2009","journal-title":"Neurol. India"},{"key":"ref_21","first-page":"163","article-title":"Radiographic evaluation of the relationship between spinal canal area and the anatomic dimensions of the spinal canal at the thoracolumbar junction in the Turkish population","volume":"30","author":"Senturk","year":"2019","journal-title":"J. Turk. Spinal Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/01.BRS.0000105537.49674.A3","article-title":"Morphometric comparison of the pedicle rib unit to pedicles in the thoracic spine","volume":"29","author":"Husted","year":"2004","journal-title":"Spine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1051\/sicotj\/2025015","article-title":"Validity of a new scoring system for assessment and decision guidance of misplaced pedicular screws","volume":"11","author":"Ahmed","year":"2025","journal-title":"SICOT J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"335","DOI":"10.13107\/jocr.2026.v16.i05.7298","article-title":"The Computed Tomography-based Morphometry of Thoracolumbar Junction (T11-L2) in Western Indian Population: Implications for Transpedicular Screw Fixation","volume":"16","author":"Yadav","year":"2026","journal-title":"J. Orthop. Case Rep."},{"key":"ref_25","first-page":"351","article-title":"Morphometric study on the 12th thoracic vertebrae which is most frequently exposed to trauma and the closest vertebra to thoracic aorta","volume":"27","author":"Korkmaz","year":"2021","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_26","first-page":"771","article-title":"Stereotactic navigation for placement of pedicle screws in the thoracic spine","volume":"48","author":"Youkilis","year":"2001","journal-title":"Neurosurgery"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1754-9493-5-33","article-title":"Unusual spine anatomy contributing to wrong level spine surgery: A case report and recommendations for decreasing the risk of preventable \u2018never events\u2019","volume":"5","author":"Lindley","year":"2011","journal-title":"Patient Saf. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s13244-013-0286-0","article-title":"The prevalence of morphological changes in the thoracolumbar spine on whole-spine computed tomographic images","volume":"5","author":"Nakajima","year":"2014","journal-title":"Insights Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3171\/SPI-07\/11\/467","article-title":"Wrong-sided and wrong-level neurosurgery: A national survey","volume":"7","author":"Jhawar","year":"2007","journal-title":"J. Neurosurg. Spine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"20130468","DOI":"10.1259\/bjr.20130468","article-title":"Virtual anthropology and forensic identification using multidetector CT","volume":"87","author":"Dedouit","year":"2014","journal-title":"Br. J. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.forsciint.2010.07.038","article-title":"The role of forensic anthropology in Disaster Victim Identification (DVI)","volume":"205","author":"Blau","year":"2011","journal-title":"Forensic Sci. 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