Prediction of posterior ligamentous complicated damage in thoracolumbar fractures utilizing non-MRI imaging strategies.
Int Orthop. 2016 Jun;40(6):1075-81
Authors: Rajasekaran S, Maheswaran A, Aiyer SN, Kanna R, Dumpa SR, Shetty AP
PURPOSE: We aimed to formulate a radiological index primarily based on plain radiographs and laptop tomography (CT) to reliably detect posterior ligamentous complicated (PLC) damage with out want for MRI.
METHODS: Sixty out of 148 consecutive thoracolumbar fractures with uncertain PLC have been assessed with MRI, CT and radiographs. PLC damage was assessed with the next radiological parameters: superior-inferior finish plate angle (SIEA), vertebral physique peak (BH), native kyphosis (LK), inter-spinous distance (ISD) and inter-pedicular distance (IPD) and correlated with MRI findings of PLC damage. Statistical evaluation was carried out to determine the predictive values for the parameters to determine PLC harm.
RESULTS: MRI recognized PLC damage in 25/60 circumstances. The ISD and LK have been discovered to be important predictors of PLC damage. On radiographs the imply LK with PLC harm was 25.86° in comparison with 21.02° with an intact PLC (p?=?zero.006). The ISD distinction was 6.70 mm in circumstances with PLC harm in comparison with 2.86 mm with an intact PLC (p?=?zero.011). In CT photos, the imply LK with PLC harm was 22.96° in comparison with 18.44° with an intact PLC ( p?=?zero.019). The ISD distinction was three.10 mm with PLC harm in comparison with 1.62 mm with out PLC harm (p?=?zero.005).
CONCLUSIONS: On plain radiographs the presence of LK higher than 20 °(CI 64-95) and ISD distinction higher than 2 mm (CI 70-97) can predict PLC damage. These tips could also be utilised within the emergency room particularly when the related value, availability and time delay in performing MRI are a priority.
PMID: 26983409 [PubMed – indexed for MEDLINE]