Lumbar spine radiographs of 28 patients with Marfan syndrome and a gen
der and age-matched control group were evaluated for scoliosis and mor
phologic changes of the L2, L3, and L4 vertebrae. No patient or contro
l subject had any serious low back problems. The Marfan patients showe
d a high incidence of scoliosis (64%). The incidence of lumbosacral tr
ansitional vertebra was also high (18%). The end plates of the vertebr
al bodies in the Marfan patients were more biconcave than in the contr
ol group. In addition, the transverse processes were longer in relatio
n to the vertebral body width in the Marfan group than in the controls
. These findings indicate that biconcave vertebral bodies can be added
to the list of skeletal manifestations of the Marfan syndrome, and Ma
rfan syndrome to the list of differential diagnoses for biconcave vert
ebrae (''codfish vertebrae'').