AbstractObjectivesThis study evaluates whether sacralization of a lumbar vertebra and lumbarization of a sacral vertebra are a paired duality but with opposite expressions; the former is associated with 23 presacral vertebrae (PSV) and the latter with 25 PSV. Are sacralization and lumbarization local phenomena, involving only vertebra (V) 24 and V25, or are they associated with other costal‐vertebral transformations?Materials and MethodsStudy sample is of skeletonized humans, 431 females and 1405 males, who were 20–49 years of age‐at‐death and who died in the United States in the 20th and 21st centuries. Data collected are numbers of PSV and sacral vertebrae, presence of rib of V7, position of diaphragmatic vertebra, and transverse process and rib lengths of V5–V9, V18–V19, and V21–V22.ResultsFemales and males differ significantly in numbers of PSV. Both sexes show significant differences among individuals with 23 PSV, 24 PSV, and 25 PSV: (1) individuals with 23 PSV have the shortest ribs, whereas those with 25 PSV have the longest ribs, of V18 and V19; and (2) individuals with 23 PSV have the highest frequency of 6 sacral vertebrae, whereas those with 25 PSV have the highest frequency of 5 sacral vertebrae.DiscussionIndividuals with 23 PSV and 25 PSV show posterior and anterior homeotic transformation, respectively, of the thoracic‐lumbar and lumbar‐sacral boundaries, but only individuals with 25 PSV show transformation of the sacral–coccygeal boundary. As co‐occurring costal‐vertebral transformations differ between sacralization and lumbarization, inferentially the set of genes that influences these vertebrae also differs.