MRI findings of thoracolumbar spine fractures: a categorisation based on MRI examinations of 100 fractures

Abstract 

Objective. To define the state of different structures of the fractured thoracolumbar spine which may play a role in the immediate and long-term mechanical stability on MR images and to investigate the relationship of these findings with the AO classification of spinal injuries.

Design. The state of the anterior longitudinal ligament, posterior longitudinal ligament, posterior ligamentous complex, cranial and caudal endplates, cranial and caudal discs and the vertebral body were defined using clinical, experimental and radiological data. The state of these structures was reported for each fracture on the MRI examinations and the different MRI features appropriate for different fracture classes were defined.

Patients. MRI examinations of 70 patients with 100 fractures of the thoracolumbar spine were used for this study.

Results. Wide variations were seen in the state of the structures studied. We could not find a definite pattern to relate these findings with the AO classification scheme.

Conclusions. MR findings should be integrated into future classification schemes of thoracolumbar spine fractures. This would enable specific data about the structures involved in the stability of the spine to be acquired. Prospective studies using the criteria developed in this study may help resolve some of the controversies concerning the diagnosis and prognosis of these injuries as well as the development of new classification systems.