Can burst fractures be predicted from plain radiographs?

Ballock, RT; Mackersie, Robert C.; Abitbol, Jean Jacques; Cervilla, V; Resnick, Donald; Garfin,

doi:10.1302/0301-620x.74b1.1732246

Cited by 89 publications

(12 citation statements)

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“…In terms of assessing injuries of the T/L spine, anteroposterior and lateral radiographs dedicated to the T/L spine is an option. In fact, certain studies state these Xrays are the gold standard [ 10 , 11 ]. Plain film radiographs cost less, expose the patient to lower doses of radiation, and, most importantly, are available in most institutions.…”

Section: Discussionmentioning

confidence: 99%

A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

2011

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BackgroundPatients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH). Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury.Case presentationA man struck by a motor vehicle suffered multiple traumatic injuries including numerous rib fractures, a mechanically unstable pelvic fracture, and also had suspicion for an aortic injury. Unfortunately, the upper thoracic segment (T1-5) was only visualized with axial images based on the electronic data. Several days later, a contrast CT scan obtained to check the status of suspected aortic injury revealed T3-T4 subluxation indicative of an unstable extension-type fracture in the setting of DISH. Due to the missed injury and delay in diagnosis, surgery was not performed until eight days after the injury. At surgery, the patient was found to have left T3-T4 facet joint infection as well as infected hematoma surrounding a left T4 transverse process fracture and a traumatic T4 costo-transverse joint fracture-subluxation. Despite presence of infection, an instrumented posterior spinal fusion from T1-T6 was performed and the patient recovered well after antibiotic treatment.ConclusionA T3-T4 unstable DISH extension-type fracture was initially missed in a polytrauma patient due to inadequate imaging acquisition, which caused a delay in treatment and bacterial seeding of fracture hematoma. Complete imaging is especially needed in obtunded patients that cannot be thoroughly examined.

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Section: Discussionmentioning

confidence: 99%

A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

2011

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“…This result was consistent with the findings of previous 2 studies. Ballock et al 13 examined the accuracy of plain radiography alone for detecting burst fractures. Their study included 67 frac- Figure 2.…”

Section: Discussionmentioning

confidence: 99%

Plain Radiography Versus Computed Tomography Scans in the Diagnosis and Management of Thoracolumbar Burst Fractures

Dai

Wang²,

Jiang³

et al. 2008

Spine

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“…In traumatic thoracolumbar fractures, the reported sensitivity of radiographs ranges from 49% to 62% at the thoracic level and from 67% to 82% at the lumbar level (33)(34)(35). In addition, the severity of vertebral fractures may be underrated in radiographs, with up to 25% of burst fractures misdiagnosed as wedge compression fractures (36). Therefore, CT must be performed even after detection of a vertebral fracture in radiographs for proper grading.…”

Section: Traumatic Pathologymentioning

confidence: 99%

The role of radiography in the study of spinal disorders

Santiago¹,

Ramos‐Bossini²,

Wáng³

et al. 2020

Quant Imaging Med Surg

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Despite the growing use of computed tomography (CT) and magnetic resonance imaging (MRI) in the study of spinal disorders, radiography still plays an important role in many conditions affecting the spine. However, the study and interpretation of spine radiograph is receiving less attention and radiologists are increasingly unfamiliar with the typical findings in normal and pathologic conditions of the spine. The aim of this article is to review the radiologic indications of radiograph in different pathologic conditions that affect the spine, including congenital, traumatic, degenerative, inflammatory, infectious and tumour disorders, as well as their main radiographic manifestations.

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Can burst fractures be predicted from plain radiographs?

Cited by 89 publications

References 0 publications

A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

Plain Radiography Versus Computed Tomography Scans in the Diagnosis and Management of Thoracolumbar Burst Fractures

The role of radiography in the study of spinal disorders

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