Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Bajamal, Abdul Hafid; Permana, Khrisna Rangga; Faris, Muhammad; Zılelı, Mehmet; Peev, Nikolay

doi:10.14245/ns.2142650.325

Cited by 7 publications

(4 citation statements)

References 45 publications

(80 reference statements)

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“…Torakolomber fraktür, omurgada en sık gözlenen patolojidir. Tüm spinal kırıkların yaklaşık %90'ını torakal ya da lomber fraktürler oluşturmaktadır.Yüksek enerjili travmalar olduğu için başka sistemlerin de etkilendiği görülmektedir (3,4). Kompansatuar vertebra dizilim aralığını aşan, konservatif tedaviye cevap vermeyen ve ilerleyici nörolojik defisiti olan hastalarda cerrahi tedavi gerekmektedir (5).…”

Section: Introductionunclassified

Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

ERDOGAN

CEMAN

2023

Harran Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Travmatik vertebral kırıkların çoğu torakolomber bileşkede ,lomber omurgada , daha az sıklıkla orta torasik ve üst torasik omurgada meydana gelir. Bu çalışma ile akut travmatik torakolomber kırıklardan sonra vertebral stabilizasyon yapılan vakaların retrospektif multifaktöriyel değerlendirilmesi amaçlanmıştır. Materyal ve Metot: 2020-2022 yılları arasında, akut travmatik torakolomber kırıklardan sonra vertebral stabilizasyon yapılan 60 hasta, postop retrospektif olarak ele alındı. Her hastanın klinik verileri, kırığın tipi ve yeri, nörolojik hasarın varlığı, cerrahi öncesi ve sonrası radyolojik ölçümleri, postop komplikasyonları, reoperasyon, AO Spine ve ASIA sınıflamala verileri değerlendirildi. Bulgular:Hastların yaş ortalaması 33,5+16,2 idi. Hastaların travma etiyolojisine bakıldığında, en sık olarak %68,3 ile düşme, ikinci sırada %13.3 ile AİTK ve intihar, %3.3 ile de ADTK gözlemlenmiştir. Lokalizasyona bakıldığında 20 hastada travma L1kırığı gözlendi. 28 hastada tip B kırığı görüldü. 53 hastada herhangi bir komplikasyon görülmezken 5 hastaya revizyon cerrahisi yapıldı. Preoperatif ASIA A olan hastanın postoperatif nörolojik muayenesinin değişmediği görüldü. SonuçTorakolonber kırıklar genelikle yüksek enerjili travmadan sonra meydana gelir. Sıklıkla torakolomber bileşkede görülür ve nörolojik defistlerle yol açar. Komplet defisit olan hastalarda nörolojik iyileşme sınırlı olmaktadır. Ancak inkomplet kırıklarda nörolojik düzelme gözlenebilmektedir. Hastaların ivedilikle tedavisine başlanmalı ve rutin hayatına dönmesi sağlanmalıdır.

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Section: Introductionunclassified

Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

ERDOGAN

CEMAN

2023

Harran Üniversitesi Tıp Fakültesi Dergisi

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“…To assist in the diagnosis and treatment of vertebral fractures, many classification systems for vertebral fractures have been developed (3)(4)(5)(6). In 2013, Vaccaro et al incorporated a modified classification system called the AOSpine thoracolumbar spine injury classification system (7), which is a widely accepted and comprehensive classification system used for clinical practice and research (8,9).…”

Section: Introductionmentioning

confidence: 99%

“…To assist in the diagnosis and treatment of vertebral fractures, many classification systems for vertebral fractures have been developed ( 3 – 6 ). In 2013, Vaccaro et al.…”

Section: Introductionmentioning

confidence: 99%

Automated detection and classification of acute vertebral body fractures using a convolutional neural network on computed tomography

Zhang

Liu²,

Xu³

et al. 2023

Front. Endocrinol.

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BackgroundAcute vertebral fracture is usually caused by low-energy injury with osteoporosis and high-energy trauma. The AOSpine thoracolumbar spine injury classification system (AO classification) plays an important role in the diagnosis and treatment of the disease. The diagnosis and description of vertebral fractures according to the classification scheme requires a great deal of time and energy for radiologists.PurposeTo design and validate a multistage deep learning system (multistage AO system) for the automatic detection, localization and classification of acute thoracolumbar vertebral body fractures according to AO classification on computed tomography.Materials and MethodsThe CT images of 1,217 patients who came to our hospital from January 2015 to December 2019 were collected retrospectively. The fractures were marked and classified by 2 junior radiology residents according to the type A standard in the AO classification. Marked fracture sites included the upper endplate, lower endplate and posterior wall. When there were inconsistent opinions on classification labels, the final result was determined by a director radiologist. We integrated different networks into different stages of the overall framework. U-net and a graph convolutional neural network (U-GCN) are used to realize the location and classification of the thoracolumbar spine. Next, a classification network is used to detect whether the thoracolumbar spine has a fracture. In the third stage, we detect fractures in different parts of the thoracolumbar spine by using a multibranch output network and finally obtain the AO types.ResultsThe mean age of the patients was 61.87 years with a standard deviation of 17.04 years, consisting of 760 female patients and 457 male patients. On vertebrae level, sensitivity for fracture detection was 95.23% in test dataset, with an accuracy of 97.93% and a specificity of 98.35%. For the classification of vertebral body fractures, the balanced accuracy was 79.56%, with an AUC of 0.904 for type A1, 0.945 for type A2, 0.878 for type A3 and 0.942 for type A4.ConclusionThe multistage AO system can automatically detect and classify acute vertebral body fractures in the thoracolumbar spine on CT images according to AO classification with high accuracy.

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“…Reports of a high prevalence of lumbar spine abnormalities seen on MRI in asymptomatic subjects are also available (Hebelka H et al, 2019;Jiang X, Chen D et al, 2018;Kim JH et al, 2018). In addition, a false positive imaging on MRI can lead to inappropriate therapy, increase the cost of treatment and result in suboptimal treatment (Bajamal AH et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of contrast and non-contrast 1.5 tesla magnetic resonance imaging for lumbar herniated nucleus pulposus based on surgical findings

Harmawan

Apriawan

Subagio

et al. 2022

ijhs

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This study aims to provide the latest information regarding the accuracy of contrast and non-contrast 1.5 Tesla MRI in the diagnosis of lumbar Herniated Nucleus Pulposus (HNP) compared with surgical findings. We included studies with subjects diagnosed with lumbar HNP due to degenerative processes, preoperative 1.5 Tesla contrast, and non-contrast MRI and described the number of findings of MRI diagnostic tests (index test) on the actual conditions found during surgery (reference standard). We searched literature from 5 databases: ProQuest, Pubmed, Cochrane Library, Biomed Central, and ScienceDirect. The sensitivity and specificity of contrast and non-contrast 1.5 Tesla MRI ranged between 64-95% and 55-100% (95% CI) with the area under the curve above the threshold on the ROC curve. Two studies compared the accuracy of MRI and Computed Tomography (CT) myelography with a wider ROC curve on CT myelography than on MRI. The ROC curve which has a wide area under the curve above the threshold depicts the relationship between sensitivity and specificity, shows that contrast non-contrast 1.5 Tesla MRI has a good accuracy in HNP diagnostic.

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Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Cited by 7 publications

References 45 publications

Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

Automated detection and classification of acute vertebral body fractures using a convolutional neural network on computed tomography

Diagnostic accuracy of contrast and non-contrast 1.5 tesla magnetic resonance imaging for lumbar herniated nucleus pulposus based on surgical findings

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