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Research ArticleLumbar Spine

Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine

David Shin, Kai Nguyen, Easton Small, Trevor Case, Mikayla Kricfalusi, Alexander Bouterse, Andrew Cabrera, Ethan Purnell, Wheddy Laguerre, Jacob Razzouk, Omar Ramos, Olumide Danisa and Wayne Cheng
International Journal of Spine Surgery September 2024, 8651; DOI: https://doi.org/10.14444/8651
David Shin
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Kai Nguyen
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Easton Small
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Trevor Case
2 School of Medicine, California University of Science and Medicine, Colton, CA, USA
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Mikayla Kricfalusi
2 School of Medicine, California University of Science and Medicine, Colton, CA, USA
BS
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Alexander Bouterse
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Andrew Cabrera
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Ethan Purnell
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Wheddy Laguerre
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
BS
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Jacob Razzouk
1 School of Medicine, Loma Linda University, Loma Linda, CA, USA
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Omar Ramos
3 Department of Orthopedic Surgery, Twin Cities Spine Center, Minneapolis, MN, USA
MD
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Olumide Danisa
4 Department of Orthopaedic and Neurological Surgery, Duke University Healthcare Center, Durham, NC, USA
MD
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Wayne Cheng
5 Division of Orthopedic Surgery, Jerry L Pettis Memorial Veterans Hospital, Loma Linda, CA, USA
MD
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  • For correspondence: md4spine@yahoo.com
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    Figure 1

    Location of the umbilicus in relation to the lumbar spine (n = 624).

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    Figure 2

    Influence of patient sex on the location of the umbilicus and iliac crests in relation to the lumbar spine.

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    Figure 3

    Influence of race and ethnicity on the location of the umbilicus and iliac crests in relation to the lumbar spine.

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    Figure 4

    Location of the left iliac crest in relation to the lumbar spine (n = 832).

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    Figure 5

    Location of the right iliac crest in relation to the lumbar spine (n = 831).

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    Table

    Enter-method linear regression modeling of patient height, weight, sex, and ethnicity in relation to the umbilicus and iliac crests.

    MetricUmbilicusLeft Iliac CrestRight Iliac Crest
    ANOVA P value0.002<0.001<0.001
    R 2 0.0570.1200.109
    SE0.4720.4000.396
    Constant4.8785.1745.612
    B coefficient—height−0.489−0.357−0.662
    B coefficient—weight0.0030.0010.001
    B coefficient—sex−0.075−0.245−0.168
    B coefficient—ethnicity−0.0380.0230.035
    • Abbreviation: ANOVA, analysis of variance.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine
David Shin, Kai Nguyen, Easton Small, Trevor Case, Mikayla Kricfalusi, Alexander Bouterse, Andrew Cabrera, Ethan Purnell, Wheddy Laguerre, Jacob Razzouk, Omar Ramos, Olumide Danisa, Wayne Cheng
International Journal of Spine Surgery Sep 2024, 8651; DOI: 10.14444/8651

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Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine
David Shin, Kai Nguyen, Easton Small, Trevor Case, Mikayla Kricfalusi, Alexander Bouterse, Andrew Cabrera, Ethan Purnell, Wheddy Laguerre, Jacob Razzouk, Omar Ramos, Olumide Danisa, Wayne Cheng
International Journal of Spine Surgery Sep 2024, 8651; DOI: 10.14444/8651
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Keywords

  • anatomic
  • computed tomography
  • ethnicity
  • iliac crest
  • race

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