Analysis of the Combined Computed Tomography Findings Improves the Accuracy of Computed Tomography for Detecting Posterior Ligamentous Complex Injury of the Thoracolumbar Spine as Defined by Magnetic Resonance Imaging

Letter: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma: Radiological Evaluation

“…based on the number of positive CT findings: PLC injury ≥ 2 CT findings: positive predictive value (PPV) for PLC injury is 91%, suspected PLC injury (M1 modifier) PPV 33% and intact PLC no positive CT findings PPV 9%. 7 When analyzing the impact of MRI on fracture classification using these CT/MRI criteria, MRI had a far less influence on fracture classification than previously thought, changing the classification in just 10% of instances. 4 Furthermore, to help guide the indications of MRI in individual patients, we provided the rate of MRI reclassification for each fracture subtype depending on PLC status (injured, suspected, and intact).…”

“…7 We have previously shown that using high-signal intensity may reduce CT sensitivity for PLC injury from 91% to 66%. 7 Similarly, prior research defined PLC damage in CT as any positive CT finding of PLC injury, regardless of the variable or added predictive value of CT findings. We have shown that the following 4 CT findings are independent predictors for PLC injury: spinous process fracture, horizontal laminar fracture, facet diastasis, and interspinous widening >4 mm.…”

“…We have shown that the following 4 CT findings are independent predictors for PLC injury: spinous process fracture, horizontal laminar fracture, facet diastasis, and interspinous widening >4 mm. 7 We proposed the following definition of PLC status in CT based on the number of positive CT findings: PLC injury ≥ 2 CT findings: positive predictive value (PPV) for PLC injury is 91%, suspected PLC injury (M1 modifier) PPV 33% and intact PLC no positive CT findings PPV 9%. 7…”

“…7 We proposed the following definition of PLC status in CT based on the number of positive CT findings: PLC injury ≥ 2 CT findings: positive predictive value (PPV) for PLC injury is 91%, suspected PLC injury (M1 modifier) PPV 33% and intact PLC no positive CT findings PPV 9%. 7…”

“…We have shown that the following 4 CT findings are independent predictors for PLC injury: spinous process fracture, horizontal laminar fracture, facet diastasis, and interspinous widening >4 mm. 7 We proposed the following definition of PLC status in CT…”