Can you diagnose for vertebral fracture correctly by plain X-ray?

Ito, Zenya; Harada, Atsushi; Matsui, Yasumoto; Takemura, Marie; Wakao, Norimitsu; Suzuki, Tetsuya; Nishizaki, Takashi; Kawatsu, Shoji; Shimokata, Hiroshi; Ishiguro, Naoki

doi:10.1007/s00198-006-0123-0

Cited by 39 publications

(28 citation statements)

References 21 publications

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“…Hairline fractures or non-displaced fractures are difficult to detect on conventional radiographs. In patients with osteoporosis, a wrong diagnosis of latent vertebral fracture is often made when it is based on plain X-ray imaging [22]. In the cervical spine, plain X-ray films detect only 60-80% of fractures; a significant number of fractures are not visible, even when three views of the spine are obtained [23].…”

Section: Plain X-ray Filmsmentioning

confidence: 99%

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Trauma of the spine and spinal cord: imaging strategies

et al. 2009

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Traumatic injuries of the spine and spinal cord are common and potentially devastating lesions. We present a comprehensive overview of the classification of vertebral fractures, based on morphology (e.g., wedge, (bi)concave, or crush fractures) or on the mechanism of injury (flexion-compression, axial compression, flexiondistraction, or rotational fracture-dislocation lesions). The merits and limitations of different imaging techniques are discussed, including plain X-ray films, multi-detector computed tomography (MDCT), and magnetic resonance imaging (MRI) for the detection. There is growing evidence that state-of-the-art imaging techniques provide answers to some of the key questions in the management of patients with spine and spinal cord trauma: is the fracture stable or unstable? Is the fracture recent or old? Is the fracture benign or malignant? In summary, we show that high-quality radiological investigations are essential in the diagnosis and management of patients with spinal trauma.

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Section: Plain X-ray Filmsmentioning

confidence: 99%

“…At the time of injury, the average age of patients with traumatic spine lesions is 32 years and 55% of those injured are aged [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] years. Approximately, half of spinal injuries occur in the cervical spine, the other half involves the thoracic, lumbar, and sacral areas.…”

Section: Introductionmentioning

confidence: 99%

Trauma of the spine and spinal cord: imaging strategies

et al. 2009

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“…It is recommended that in severe spinal trauma CT should be the first imaging modality 10 . In the cervical spine, plain radiography detect only 60-80% of fractures; a significant number of fractures are not visible, even when three views of the spine are obtained 10,11 . Despite of the limitation, Radiography remains appropriate in low-risk subjects, as well as in those situations where CT is not available.…”

Section: Introductionmentioning

confidence: 98%

“…Plain radiography, even with the best possible technique, underestimate the amount of traumatic spine injury, and abnormalities may be missed. It has been shown that 23-57% of spinal fractures are missed by standard radiography compared to multi-detector (multislice) Computed tomography (CT) 9 . It is recommended that in severe spinal trauma CT should be the first imaging modality 10 .…”

Section: Introductionmentioning

confidence: 99%

Aetiology and Imaging Findings in Traumatic Spine Injury among Patients Attending Muhimbili Orthopedics Institute in Dar es Salaam

Mboka¹,

Sohal²,

Kazema³

2017

East. Cent. Afr. J. Surg.

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Background: The main objective of the study was to determine etiology and imaging features of traumatic spine injury in spine injured patients attending Muhimbili orthopedics institute Methods: The study was a hospital based cross-sectional and consecutively included 87 with traumatic Spine Injury. Data was collected through a structured questionnaire. Statistical package for social science (SPSS 20) was used for data analysis. Results: Eight seven (87) patients with traumatic spine injury were studied. The age range was 4 to 81 years, with a mean age of 33 years. Males were more affected than females. Young individuals aged 16-30 years were the most affected. The commonest cause of spine trauma was motor traffic crashes. The commonest vertebral spine injury seen was compression wedge fracture (35.6%), followed by dislocation (18.4%). The most frequent spine level involved was lumbar spine (37.9%). Paraplegia (33.3%) and quadriplegia (10.3%) were the common clinical presentations. Fifty six percent of patients had associated injuries Conclusion: Traumatic spine injury is common at our settings. Young individuals below 30 years of age are most affected and the most common cause is motor traffic accident (MTA). The use of Computed Tomography (CT) in this study helped to identify several types of injuries especially injury to vertebral bodies and their effect unto neuro structures. MRI helped to identify patients with spinal cord injury which was not evident on CT.

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“…Plain dynamic loading radiography involves taking images of the lateral surface of the vertebral body in both postures and calculating changes in vertebral height between the two. This method is believed to significantly improve the accuracy of the diagnosis of fresh fractures at the time of the first visit [5] compared to conventional bidirectional plain radiography, which is performed in the supine position for anterior-posterior imaging and in the side-lying non-loaded position for lateral imaging [17]. In addition, by using images obtained from plain dynamic loading radiography to measure differences in vertebral collapse rate in the standing/sitting and supine position, instability of the fractured vertebral body in a loaded posture and non-loaded posture can be evaluated.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs

Funayama¹,

Tsukanishi²,

Abe³

et al. 2017

J Spine

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Purpose: To elucidate the association between computed tomography (CT)/magnetic resonance imaging (MRI) and radiographic findings of fractured vertebral body instability in patients with osteoporotic vertebral fractures and to clarify whether resistance to conservative treatment can be evaluated on the basis of dynamic loading radiography.Methods: Seventy-eight patients aged ≥ 65 years who underwent conservative treatment for osteoporotic single vertebral fractures of the thoracolumbar junction were divided into the conservative treatment-resistant group (18 patients) and control group (60 patients). We evaluated the accuracy of the prediction of resistance to conservative treatment on the basis of the CT/MRI findings and the difference in compression rates between standing and supine positions at the time of the first visit. The differences in compression rates (%) were compared between the two groups. In addition, a receiver operating characteristics (ROC) curve was drawn to evaluate the accuracy of the prediction of resistance to conservative treatment. Results:In patients without (47 cases) and with CT findings (31 cases), the mean differences in compression rates (%) was 8.9% and 19.1%, respectively (p=0.0029). The mean differences in compression rates (%) of patients without (60 cases) and with MRI findings (18 cases) was 9.7% and 24.0%, respectively (p=0.0043). The mean differences in compression rates (%) in the conservative treatment-resistant group was 26.3%, while that in the control group was 9.0 (p=0.0066). In addition, according to the ROC curve of the difference in compression rate was 0.93 (95% confidence interval: 0.87-1), and when a 20% difference in compression rate was considered as the threshold value.Conclusion: Dynamic loading radiography is useful for the evaluation of resistance to conservative treatment in patients with osteoporotic vertebral fractures, and that a compression rate difference of ≥ 20% predicts resistance to conservative treatment.

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Can you diagnose for vertebral fracture correctly by plain X-ray?

Cited by 39 publications

References 21 publications

Trauma of the spine and spinal cord: imaging strategies

Trauma of the spine and spinal cord: imaging strategies

Aetiology and Imaging Findings in Traumatic Spine Injury among Patients Attending Muhimbili Orthopedics Institute in Dar es Salaam

Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs

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