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Assessment of acute thoracolumbar fractures: challenges in multidetector computed tomography and added value of emergency MRI.

Acute thoracolumbar fractures are commonly diagnosed by clinical symptoms and X-ray plain films. Computed tomography (CT) is used to assess vertebral body damage, posterior wall canal intrusion, and posterior column injury. Both of these imaging tools have helped to develop classifications systems t...

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Published in:Seminars in Musculoskeletal Radiology Vol. 17; no. 4; pp. 389 - 396
Main Authors: Pizones, Javier, Castillo, Ernesto
Format: Journal Article
Published: Thieme Medical Publishing Inc. Sep2013
Online Access:View this record in EBSCOhost
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        10897860
        NSJ
      jtl: Seminars in Musculoskeletal Radiology
      issn: 10897860
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      dt: Sep2013
      vid: 17
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      pub: Thieme Medical Publishing Inc.
      place: New York, New York
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        104103140
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        10.1055/s-0033-1356468
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        atl: Assessment of acute thoracolumbar fractures: challenges in multidetector computed tomography and added value of emergency MRI.
      aug:
        au:
          Pizones, Javier
          Castillo, Ernesto
        affil: Department of Orthopaedic Surgery, Spine Unit, Hospital Universitario de Getafe.
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Multidetector Computed Tomography
          Soft Tissue Injuries Diagnosis
          Spinal Fractures Diagnosis
          Algorithms
          Emergencies
          Spinal Fractures Radiography
      ab: Acute thoracolumbar fractures are commonly diagnosed by clinical symptoms and X-ray plain films. Computed tomography (CT) is used to assess vertebral body damage, posterior wall canal intrusion, and posterior column injury. Both of these imaging tools have helped to develop classifications systems that aid the clinician in differentiating stable versus unstable spinal injuries. Multidetector CT has become the standard of care in polytrauma patients. It provides superior evaluation of bony anatomy and has been reported to be more cost effective than X-ray plain films, particularly in the cervicothoracic junction and in thoracolumbar unstable burst fractures. One disadvantage might be the increase in radiation exposure. Another important limitation remains the inability to provide adequate assessment for ligamentous injury and spinal cord lesions. Disc and ligaments play an important role in fracture stability because the failure of the posterior tension band may lead to progressive kyphosis. The integrity of the posterior ligamentous complex has been included in recent fracture classification systems and treatment algorithms. MR imaging becomes essential for soft tissue injury assessment, especially when including T2-weighted sequences with fat suppression. MRI can now be considered key to accurate fracture classification, detection of occult and distant injuries, and as the basis for therapeutic decision making. It is therefore strongly recommended in the early assessment of spine trauma patients.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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