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Magnetic resonance imaging frequently changes classification of acute traumatic thoracolumbar spine injuries


Winklhofer, Sebastian; Thekkumthala-Sommer, Merly; Schmidt, Diethard; Rufibach, Kaspar; Werner, Clément Ml; Wanner, Guido A; Alkadhi, Hatem; Hodler, Jürg; Andreisek, Gustav (2013). Magnetic resonance imaging frequently changes classification of acute traumatic thoracolumbar spine injuries. Skeletal Radiology, 42(6):779-786.

Abstract

OBJECTIVE: To evaluate the influence of additional (MRI) compared with computed tomography (CT) alone for the classification of traumatic spinal injuries using the Arbeitsgemeinshaft für Osteosynthesefragen (AO) system and the Thoraco-Lumbar Injury Classification and Severity (TLICS) scale. MATERIALS AND METHODS: Images from 100 consecutive patients with at least one fracture on CT were evaluated retrospectively by three radiologists with regard to the AO and TLICS classification systems in 2 steps. First, all images from the initial CT examination were analyzed. Second, 6 weeks later, CT and MR images were analyzed together. Descriptive statistics and Wilcoxon tests were performed to identify changes in the number of fractures and ligamentous lesions detected and their corresponding classification. RESULTS: CT and MRI together revealed a total of 196 fractures (CT alone 162 fractures). The AO classification changed in 31 %, the TLICS classification changed in 33 % of the patients compared with CT alone. Based on CT and MRI together, the TLICS value changed from values < 5 (indication for conservative therapy) to values ≥ 5 (indication for surgical therapy) in 24 %. CONCLUSION: MRI of patients with thoracolumbar spinal trauma considerably improved the detection of fractures and soft tissue injuries compared with CT alone and significantly changed the overall trauma classification.

Abstract

OBJECTIVE: To evaluate the influence of additional (MRI) compared with computed tomography (CT) alone for the classification of traumatic spinal injuries using the Arbeitsgemeinshaft für Osteosynthesefragen (AO) system and the Thoraco-Lumbar Injury Classification and Severity (TLICS) scale. MATERIALS AND METHODS: Images from 100 consecutive patients with at least one fracture on CT were evaluated retrospectively by three radiologists with regard to the AO and TLICS classification systems in 2 steps. First, all images from the initial CT examination were analyzed. Second, 6 weeks later, CT and MR images were analyzed together. Descriptive statistics and Wilcoxon tests were performed to identify changes in the number of fractures and ligamentous lesions detected and their corresponding classification. RESULTS: CT and MRI together revealed a total of 196 fractures (CT alone 162 fractures). The AO classification changed in 31 %, the TLICS classification changed in 33 % of the patients compared with CT alone. Based on CT and MRI together, the TLICS value changed from values < 5 (indication for conservative therapy) to values ≥ 5 (indication for surgical therapy) in 24 %. CONCLUSION: MRI of patients with thoracolumbar spinal trauma considerably improved the detection of fractures and soft tissue injuries compared with CT alone and significantly changed the overall trauma classification.

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13 citations in Web of Science®
15 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:17 Jan 2013 07:29
Last Modified:05 Apr 2016 16:16
Publisher:Springer
ISSN:0364-2348
Publisher DOI:https://doi.org/10.1007/s00256-012-1551-x
PubMed ID:23269516

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