Imaging of Spinal Trauma

Bagley, Linda J.

doi:10.1016/j.rcl.2005.08.004

Cited by 100 publications

(57 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MR imaging with STIR or FS-T2-w sequences is able to detect BME and, therefore, determine the acuity of an injury [2]. In the present study, we show how in patients with suspicion of fracture, due to dorsal trauma with acute pain and radiographic signs of vertebral compression or spinous diastasis, MRI can rule out the presence of acute fractures, because of the lack of bone edema and endplate disruption.…”

Section: Discussionmentioning

confidence: 52%

“…Without a doubt, X-rays and CT scans are still very useful tools in detecting osseous damage and are currently used to classify fractures in most spine centers [2,13,14]. The AO classification [9], which is widely used, bases its three basic fracture patterns on the analysis of these traditional examination tools [10] and still serves as a basic instrument with which to classify fractures and to decide treatment [1].…”

Section: Discussionmentioning

confidence: 99%

“…Early classifications were designed through the analysis of plain X-rays and CT scan, which are examination tools not completely able to show soft tissue anatomy [8,10,11,13]. With these, the suspicion of ligament injury has to be assessed by indirect indicators such as focal kyphosis, interspinous spacing, diastasis of the facet joints or more than 50% of anterior body compression [2,16,17].…”

Section: Introductionmentioning

confidence: 99%

“…Subsequently, we have learned that discs and ligaments play an important role in fracture stability and healing capability, and that these structures can be evaluated very well using MRI scans [2,20]. Vaccaro et al [18] have developed a novel classification system which includes the grading of posterior ligamentous complex (PLC) injury.…”

Section: Introductionmentioning

confidence: 99%

“…This system has proven to be very helpful in identifying posterior instability and to set a guide for treatment. Consequently, recent studies propose that acute fractures should be analyzed with both CT and MRI scans [2,8,13,14], or even only MRI scans [10,21], to fully understand the extent of the injury and its grade of instability. However, little information is available regarding the impact and accuracy of MRI on fracture diagnosis and its help in treatment decision making.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment

et al. 2011

View full text Add to dashboard Cite

Introduction The role of magnetic resonance imaging (MRI) has recently been enhanced in the diagnosis of thoracolumbar fractures due to its ability to examine soft tissue injury. Material and methods We conducted a prospective study to analyze the usefulness of MRI in fracture diagnosis and its influence on treatment decision making. Thirty-three patients were enrolled after suffering an acute traumatic thoracolumbar fracture. Osteoporotic or pathologic fractures were excluded. Fractures were initially classified using X-ray and CT scan following the AO classification. Afterward, a selective MRI protocol was performed with T1 and T2-weighted FS/STIR sequences. Subsequently, fractures were classified according to the TLICS system and reclassified following the AO system. Analysis was performed before and after MRI, focusing on: diagnostic changes, occult fractures and differences in treatment decision making. Results Thirty patients (15 males, 15 females) with an average age of 39.9 years were studied. Forty-one fractures were initially diagnosed using plain X-rays and CT scans, while MRI diagnosed 50 fractures and 9 vertebral contusions. MRI modified our diagnosis in 40% of our patients (discovering 18 occult injuries), the classification of fracture pattern in 24% of the fractures (mostly upgrading type A to type B patterns) and the therapeutic management in 16% of our patients. Conclusions MRI seems to be a useful tool in the evaluation of thoracolumbar acute fractures, as it allows a better visualization of the posterior complex integrity and of the levels involved, offering additional information compared to traditional diagnostic tools.

show abstract

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment

et al. 2011

View full text Add to dashboard Cite

show abstract

Triage tools for detecting cervical spine injury in pediatric trauma patients

Slaar

Fockens

Wang

et al. 2015

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Triage tools for detecting cervical spine injury in pediatric trauma patients

Slaar

Fockens

Wang

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

There are currently few studies assessing the diagnostic test accuracy of the NEXUS criteria and CCR in children. At the moment, there is not enough evidence to determine the accuracy of the Canadian C-spine Rule to detect CSI in pediatric trauma patients following blunt trauma. The confidence interval of the sensitivity of the NEXUS criteria between the individual studies showed a wide range, with a lower limit varying from 0.18 to 0.91 with a total of four false negative test results, meaning that if physicians use the NEXUS criteria in children, there is a chance of missing CSI. Since missing CSI could have severe consequences with the risk of significant morbidity, we consider that the NEXUS criteria are at best a guide to clinical assessment, with current evidence not supporting strict or protocolized adoption of the tool into pediatric trauma care. Moreover, we have to keep in mind that the sensitivity differs among several studies, and individual confidence intervals of these studies show a wide range. Our main conclusion is therefore that additional well-designed studies with large sample sizes are required to better evaluate the accuracy of the NEXUS criteria or the Canadian C-spine Rule, or both, in order to determine whether they are appropriate triage tools for the clearance of the cervical spine in children following blunt trauma.

show abstract

Imaging of Spinal Trauma

Cited by 100 publications

References 47 publications

Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment

Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment

Triage tools for detecting cervical spine injury in pediatric trauma patients

Triage tools for detecting cervical spine injury in pediatric trauma patients

Contact Info

Product

Resources

About