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Dear Editor, We have read the article “Spinal Enumeration by Morphologic Analysis of Spinal Variants: Comparison to Counting in a Cranial-To-Caudal Manner” with great interest (1). When counting the vertebral number using the traditional method (2) under the assumption that there are seven cervical and twelve thoracic vertebrae, we usually apply the segmental variation exclusively to the lumbosacral vertebrae. Although we find the thoracolumbar morphological variants in a significant number of patients, we have no choice but to use the traditional method because it is difficult to perform the morphological analysis of the spine without the computed tomography (CT) images. In our hospital, when we perform magnetic resonance imaging (MRI) of a spine, we do not always perform spine CT. Commonly, the spine can be examined through the

RE: Spinal Enumeration by Morphologic Analysis of Spinal Variants: Comparison to Counting in a Cranial-To-Caudal Manner