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

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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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Acknowledgements

We thank Marina Elliott for reading our manuscript as a native speaker.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland

    Sebastian Winklhofer, Merly Thekkumthala-Sommer, Diethard Schmidt, Hatem Alkadhi, Jürg Hodler & Gustav Andreisek

  2. Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zürich, Hirschengraben 84, 8001, Zürich, Switzerland

    Kaspar Rufibach

  3. Division of Trauma Surgery, Department of Surgery, University Hospital Zürich, Rämistrasse 100, Zürich, Switzerland

    Clément ML Werner & Guido A Wanner

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  1. Sebastian Winklhofer
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  2. Merly Thekkumthala-Sommer
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  9. Gustav Andreisek
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Correspondence to Gustav Andreisek.

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Winklhofer, S., Thekkumthala-Sommer, M., Schmidt, D. et al. Magnetic resonance imaging frequently changes classification of acute traumatic thoracolumbar spine injuries. Skeletal Radiol 42, 779–786 (2013). https://doi.org/10.1007/s00256-012-1551-x

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  • DOI: https://doi.org/10.1007/s00256-012-1551-x

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