Computed tomography of thoracic and lumbar spine fractures that have been treated with Harrington instrumentation.

Abstract

Twenty patients with fractures of the thoracic and lumbar spine underwent computed tomography (CT) following Harrington distraction instrumentation and spinal fusion. CT was done to search for a cause of persistent cord or nerve root compression in those patients who failed to improve and completely recover their partial neurologic deficit (14 cases). In 6 patients seen in the late recovery period, CT was performed to evaluate the causes of pain and instability at the fracture site. Even though the image was degraded due to the artifacts generated by the metallic rods, significant information was available in each case. The most common abnormality was the presence of residual bone fragments originating in the burst fracture of a vertebral body displaced posteriorly, into the spinal canal. In patients with complications in the late recovery period, CT found exuberant callus indenting the canal or lack of fusion of the bone grafts placed in the anterolateral aspect of the vertebral bodies. This experience indicates that CT is the modality of choice for spinal canal evaluation in those patients who fail to have an optimal clinical course following fractures of the thoracic and lumbar spine treated with Harrington rods.

Superiority of Multidetector Computed Tomography With 3-Dimensional Volume Rendering Over Plain Radiography in the Assessment of Spinal Surgical Instrumentation Complications in Patients With Cancer

“…However, CT has been reported to be more accurate for imaging of the spine, 3,26,27 especially for imaging bone detail; the position of instrumentation, including pedicular screws; alignment; degree of bone fusion; and postoperative complications. 28,29 Our results confirm these findings and further show that MDCT with addition of the VR TLD series has higher sensitivity and accuracy than MDCT alone.…”

Computerized tomography after internal fixation of the spine

“…These results are reported in dorsolumbar fractures treated by Harrington rods [2,4,6,8,10,12], but it seems logical to apply postoperative CT scans to patients with other diseases and osteosynthetic materials as well. CT scanning may thus be helpful in the diagnosis of spinal instability.…”

“…In particular narrowing of the spinal canal and neural foramina are major indications for CT scanning. Other authors [2,4,6,8,10,12] have reported that position of the fragments, their relationship to the spinal canal, placement of the fixation apparatus, and of bone grafts and visualisation of soft tissues could be well documented in patients treated with Harrington instrumentation for dorsolumbar fractures. Therefore it might be useful to apply CT scans post-operatively whenever plain x-rays do not provide sufficient information.…”

Spinal fusion-hardware construct: Basic concepts and imaging review

“…Nouh MR. Spinal fusion-hardware construct imaging B in the spine, for accurate assessment of component position, particularly for positioning of pedicle screws, evaluating both spinal and construct alignment, and degree of osseous fusion [6,7,45,46] . It can also evaluate the spinal canal, and potential post-operative complications [6,7,45,46] .…”

“…It can also evaluate the spinal canal, and potential post-operative complications [6,7,45,46] . Metal-induced artifacts on CT are the results of both hardware-related factors such as hardware composition, geometry (shape), as well as location and imaging technical factors including tube current (in milli-ampere-seconds, mAs); X-ray kilovolt peak (KVp); pitch; and image reconstruction algorithm (filter) [47,48] .…”