Computed tomography in the evaluation of thoracic and lumbar spinal fracture

ABSTRACT

The accurate diagnosis of spine trauma is essential to its proper management, since therapeutic decisionsdepend on radiography and clinical data. Failure to recognize significant injury to the spine can lead to severeneurological deficit in the previously neulogically intact patient. The developmemt of CT has open a new demensionin evaluation of spinal column. In our experience CT not only offer the accurate and thorough evaluation of spinalinjury, but does so in a rapid and more efficient manner when compared with conventional radiolgraphy. CT hasbecome the diagnostic procedure of choice when screening plain film and clinical examination indecate that acomprehensive radiographic evaluation is necessary. Eighteen patients with thoracic and lumber spinal fracturewere studied with CT. Four had multiple level injuries. The resuls are summerized as follow; 1. Among the 18patients, 4 had multiple level injuries and other 14 patients had single spinal injury. 2. 8 patients (11 spines)had simple compression fracture and 12 patients (13 spines) had burst fracture of vertebral body. 3. 15 spinesamong the 24 involved spines are located at T12 and L1 level. 4. Spineal canal narrowing and bony fragment in thecanal are defiend only 7 of 13 spines (53.8%) of burst fracture in conventional radiography. However CT showed inall spines of burst fracture. 5. Spinal posterior element involvement is suggested only one of 12 spines of burstfracture, but correctly interpretated by CT in 7 spines(11 anatomical position).