Diagnostic abilities of magnetic resonance imaging in traumatic injury to the posterior ligamentous complex: the effect of years in training

Crosby, Colin G.; Even, Jesse L.; Song, Yanna; Block, John J.; Devin, Clinton J.

doi:10.1016/j.spinee.2011.07.005

Cited by 40 publications

(37 citation statements)

References 16 publications

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“…In general, ligamentous disruption is best appreciated on fat-suppressed sequences like T 2 and short tau inversion-recovery owing to suppression of the background fatty signal, rendering the abnormal high fluid signal more obvious. 23 Disruption of the PLC was found to be one of the good criteria for Full paper: Imaging findings of flexion hangman's fracture BJR predicting flexion; however, some non-flexion cases in this series also showed a degree of PLC disruption, a finding which may be related to two factors. Firstly, cases showing no flexion on lateral radiographs may originally have had a flexion vector of injury and come to rest in a neutral position.…”

Section: Discussionmentioning

confidence: 61%

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

Taif

Menon

Alrawi

et al. 2017

BJR

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Objective: To identify the flexion type of hangman's fracture on imaging studies. Methods: 38 cases of hangman's fracture were retrospectively studied and categorized into flexion and nonflexion groups. Plain radiograph, CT and MRI of these patients were evaluated; 13 radiological parameters that might define flexion injuries were measured. The data were statistically analyzed to identify good criteria and to rank them according to their importance in predicting flexion.Results: Seven radiological criteria that have the highest correlation with flexion injury were identified. These are C2-3 lower end-plate angle, C2-3 posterior body angle, interspinous angle, disc disruption (MRI), widening of interspinous distance, disruption of the posterior ligamentous complex (MRI) and angle at the fracture site. Scoring 1 point for each positive criterion, a total score of 4 predicts flexion injury with 100% sensitivity and 96.9% specificity. Score of 5 has 83.3% sensitivity and 100% specificity. Conclusion: Flexion hangman's injury can be diagnosed by the presence of four out of seven radiological criteria in the newly introduced scoring system. The authors believe that this method may help spinal surgeons in their selection of therapeutic strategy. Advances in knowledge: This study introduces fast, simple and more objective imaging criteria for the diagnosis of flexion hangman's injury and separates it from the non-flexion pattern.

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Section: Discussionmentioning

confidence: 61%

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

Taif

Menon

Alrawi

et al. 2017

BJR

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“…Recently, Javier et al [17] reported that in a prospective study performed using a standard MRI sequencing protocol including patients who have received conservative treatment, the sensitivity and specificity of MRI were 91 and 100 %, respectively. Crosby et al [2], however, reported the sensitivity and specificity of MRI for the injury in the posterior ligament complex to be lower: 83-89 % and 37-58 %, respectively. In this study, the sensitivity and specificity of MRI for the injury in the posterior ligament complex were 70.8 and 100 % when indeterminate cases were included in the intact group, and 99.1 and 48.8 % when indeterminate cases were included in the ruptured group, showing a large difference.…”

Section: Discussionmentioning

confidence: 98%

“…However, the injury in the posterior ligament complex (PLC), one of the most important elements contributing to the soft tissue especially to the stability of the spine, has depended on magnetic resonance imaging (MRI) for its diagnosis. There is no doubt that MRI is the most accurate diagnosis method in assessing soft-tissue injuries [9,13,17], but according to the papers published to date, the sensitivity and specificity of MRI for diagnosing the posterior ligament complex injury in the thoracolumbar junction have been reported to be within the ranges of 79.2-100 % and 56-100 %, respectively [2,4,5,12,19,21,24]. Therefore, there is a limitation in using MRI as a single test to make a diagnosis of the injury in the posterior ligament complex and to determine the appropriate treatment method.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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In this study, in cases where it was difficult to make a diagnosis of the injury in the posterior ligament complex, based on the interspinous distance ratio (ISDR) of 120 % measured in plain X-ray in a lateral decubitus position, the sensitivity was 81.3 %, the specificity was 76.2 %, and the accuracy was 79.2 %. Therefore, measuring the ISDR will be helpful in determining whether surgical treatment is required in patients with thoracolumbar injury.

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“…[4]. Thoracolumbar injury classification and severity scores (TLICS) [5] of all cases were calculated.…”

Section: Methodsmentioning

confidence: 99%

A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial

Lyu¹,

Chen

Tang

et al. 2016

International Orthopaedics (SICOT)

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Purpose The aim of the study was to evaluate the efficacy of three different surgical procedures in the treatment of type A thoracolumbar fractures. Materials and methods Between September 2012 and January 2015, a total of 90 patients with type A thoracolumbar fractures were randomly assigned into three groups of 30 each. Patients in group A, B, and C were treated with threelevel percutaneous fixation, two-level percutaneous fixation, and three-level open fixation, respectively. Blood loss, duration of surgery, VAS scores, Cobb angles, and anterior height ratios of fractured vertebrae were collected for statistical analysis.Results The average follow-up was 17.7 months. Postoperative Cobb angles were significantly corrected and anterior height ratios of fractured vertebrae were well restored in all three groups (p < 0.01). Back pain was efficiently relieved according to VAS score change (p < 0.01). There were significant differences in values of blood loss and post-operative VAS scores (at three months) between group A and group C (p < 0.01). No significant difference concerning post-operative anterior height ratios of fractured vertebrae, Cobb angles and correction losses was observed between group A and group B (p = 0.580, 0.840, 0.215, respectively). Conclusion Percutaneous fixation not only provides the same reduction effect as open fixation, but also has an advantage of causing less operation related trauma which is beneficial to post-operative rehabilitation. The efficacy of three-level percutaneous fixation and two-level percutaneous fixation in the treatment of type A thoracolumbar fractures is not significantly different.

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Diagnostic abilities of magnetic resonance imaging in traumatic injury to the posterior ligamentous complex: the effect of years in training

Cited by 40 publications

References 16 publications

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

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

A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial

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