Another diagnostic tool in thoracolumbar posterior ligament complex injury: interspinous distance ratio

Kwon, Ki Youn; Park, Heui-Jeon; Shin, Jae Sung; Lee, Jun Pyo

doi:10.1007/s00586-016-4662-6

Cited by 12 publications

(2 citation statements)

References 23 publications

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“…According to the result, if ISD increases, the incidence of PLC injury increases. Therefore, it can be considered as a significant parameter in the diagnosis of PLC injury [27, 32,33].…”

Section: Discussionmentioning

confidence: 99%

Radiographic Parameters in Diagnosis of Posterior Ligamentous Complex Injury

et al. 2020

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Background and Aim: Diagnosing the status of the posterior ligament complex (PLC) plays an essential role in the management of patients with thoracolumbar fractures. In this study, due to the inefficiency of existing imaging modalities in the accurate detection of PLC damage, we investigated the relevance of some imaging parameters to specific guidelines for rapid PLC injury detection. Methods and Materials/Patients: In this study, 50 patients with and 50 patients without PLC injury were included. MRI, CT scan, and radiographic imaging of the thoracolumbar spine (T12-L1) were evaluated. The thoracolumbar injury classification systems such as Denis, TLICS (Thoracolumbar Injury Classification and Scoring System), and McCormack Load Sharing and radiographic parameters such as Superior Inferior Endplate Angle (SIEA), Body Height (BH), Local Kyphosis (LK), Interspinous Distance (ISD), and Interpedicular Distance (IPD) were investigated in these patients for each imaging method. Statistical analysis was performed using SPSS (Version 21). Result: The ISD and LK and BHp (Body Height Posterior) were significant predictors of PLC injury. On radiographs, the mean LK with and without PLC damage was 25.67° and 20.92°, respectively (p<0.001). The ISD difference was 6.75 mm in cases with PLC damage and 2.84 mm in cases with an intact PLC (p<0.0001). In CT images, the mean LK was 25.77° in cases with PLC damage and 18.63° in cases with an intact PLC (p<0.037). The ISD difference was 4.14 mm in patients with PLC damage and 2.19 mm in patients without PLC damage (p<0.002). The BHp difference was 9.44 mm in cases with PLC damage and 11.09 mm in cases without PLC damage (p<0.002). Conclusion: The current study suggests formulating a predictive radiological index to identify PLC injury successfully. These guidelines can be very helpful in emergency room decision-makings, especially when the cost, availability, and time of performing MRI are important concerns in patients with multiple trauma.

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“…According to the result, if ISD increases, the incidence of PLC injury increases. Therefore, it can be considered as a significant parameter in the diagnosis of PLC injury [27, 32,33].…”

Section: Discussionmentioning

confidence: 99%

Radiographic Parameters in Diagnosis of Posterior Ligamentous Complex Injury

et al. 2020

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“…Many previous studies (5)(6)(7) have reported that LOVBH is not associated with PLC or disc injuries. However, it should be noted that these studies either excluded osteoporotic fractures (7,8) or confused them with non-osteoporotic fractures (5,9) when investigating the relationship between LOVBH and PLC injuries. The bone mass of different vertebrae varies, especially between osteoporotic and non-osteoporotic vertebrae.…”

Section: Introductionmentioning

confidence: 99%

Use of Computed Tomography Compression Ratio in Diagnosis of Disc Injuries and Posterior Ligamentous Complex Injuries in Osteoporotic Thoracolumbar Compression Fractures

2021

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Background: Osteoporotic compression fractures are common among the elderly. It is important to predict the posterior ligamentous complex (PLC) and disc injuries in computed tomography (CT) scans of patients with magnetic resonance imaging (MRI) contraindications. Objectives: To determine the role of the CT compression ratio (CTCR) in diagnosing PLC and disc injuries and to compare it with the loss of vertebral body height (LOVBH) in osteoporotic thoracolumbar compression fractures. Patients and Methods: A total of 91 consecutive patients with vertebral fractures were included as the study population. The PLC and disc injuries were assessed using MRI, and the following radiological parameters were determined based on CT scans for further MRI examinations: CTCR, LOVBH, local kyphosis (LK), interspinous widening (ISW), vertebral translation (VBT), and posterior structures fractures (PSF). Statistical analysis was performed to identify the diagnostic value of CT features in PLC and disc injuries. Results: The PLC injuries were detected in 9/91 cases, and the number of disc injuries was 47/91. Neither CTCR nor LOVBH was associated with PLC injuries (P > 0.05). However, the CTCR was associated with disc injuries (P < 0.05), with an optimal threshold of 1.755 (sensitivity, 68.1%; specificity, 79.5%), while the LOVBH was not significantly associated with disc injuries. Based on the results, VBT was significantly related to PLC and disc injuries (P < 0.05). Conclusion: The injured vertebral CTCR was associated with disc injuries rather than PLC injuries, suggesting that compression fractures are relatively stable with less PLC injury. Overall, CTCR is a useful indicator reflecting the compression degree of the injured vertebrae; it is also a valid predictor of disc injuries.

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The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “surgical and research” articles in the European Spine Journal, 2017

Mulholland¹

2018

Eur Spine J

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Another diagnostic tool in thoracolumbar posterior ligament complex injury: interspinous distance ratio

Cited by 12 publications

References 23 publications

Radiographic Parameters in Diagnosis of Posterior Ligamentous Complex Injury

Radiographic Parameters in Diagnosis of Posterior Ligamentous Complex Injury

Use of Computed Tomography Compression Ratio in Diagnosis of Disc Injuries and Posterior Ligamentous Complex Injuries in Osteoporotic Thoracolumbar Compression Fractures

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “surgical and research” articles in the European Spine Journal, 2017

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