The role of imaging in the choice of correct treatment of unstable thoraco-lumbar fractures

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

“…T1/T2-w sequences in axial, sagittal and coronal planes should be carried out in these patients, because they give as much osseous information as the CT scan does, especially in T1-w sequences. We agree with other authors that the best information regarding the PLC injury is offered by the FS-T2-w and STIR sequences [6,7,17,20], which have improved soft tissue damage information when compared with X-rays and CT scans. However, even using these, we still have difficulties in discriminating between complete and incomplete ruptures of the posterior structures and, most of all, in differentiating self-healing disruptions from those that need to be surgically fixed to prevent a further collapse.…”

“…BME injuries (represented by decreased signal on T1-w images and increased signal on T2-w, STIR and FAT-SAT [20]) cannot be seen with conventional examination tools. Compression fractures (AO type A1) should have been diagnosed with traditional tools.…”

“…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.…”

Relationships between posterior ligamentous complex injury and radiographic parameters in patients with thoracolumbar burst fractures

“…Thus, the authors concluded that the PLC injury could not be determined by MRI evaluation in isolation. When ligamentous injuries are suspected, the use of a fat-suppressed MRI sequence or STIR-weighted MRI is necessary to achieve accurate results [15,25,26]. Crosby et al reported that sagittal STIR-weighted MRI is the ideal modality for identifying injury to the PLC components because of its highly fluid-sensitive characteristic that shows the reactive oedema of ligamentous structures after injury [11].…”

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

“…Adequate radiologic evaluation is important not only to determine the presence and severity of injury but also to guide management. 1,2 Plain radiography including anteroposterior and lateral views of the spine column are usually standard methods, and will demonstrate the characteristic features such as loss of vertebral body height, the endplate fractures, disruption of the posterior cortex of the vertebral body combined with the retrolpulsion of a fragment into the spinal canal, and increased interpedicular distance. [3][4][5][6] Although Nykamp et al 7 made their initial observations on the basis of computed tomography (CT), over the last 30 years CT has become widely used to diagnose thoracolumbar fractures.…”