Radiologic Characteristics of Vertebral Artery Injury in the Cervical Spine Fracture (경추부 골절에서 척추 동맥 손상의 방사선학적 특징)

안면환; 공병식; 김정래; 신지훈

Radiologic Characteristics of Vertebral Artery Injury in the Cervical Spine Fracture

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2011, 18(3), pp.91-95
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

안면환 ¹, 공병식 ¹, 김정래 ¹, 신지훈 ¹

¹영남대학교

Accredited

ABSTRACT

Study Design: A retrospective study. Objectives: This study was performed by probing vertebral artery injuries and their radiologic characteristics in cervical spine fractures,and analyzing MRI findings of vascular injuries. Summary of Literature Review: Vertebral artery injuries are found relatively often in cervical spine fractures. Materials and Methods: We evaluated 57 cases of cervical spine fractures that occurred beginning in June 2011 and ending in February 2003. The characteristics of each fracture were evaluated using conventional radiographs, CT, and MRI. The presence of a vertebral artery injury was based on the absence of signal void in multilevel transverse foramens. Results: Twelve out of the 57 cases (21.1%) were found to have unilateral vertebral artery injuries. Clinically, impairment in cerebral circulation was not found. We found no statistical correlation between the signal change in the spinal cord and in the vertebral artery injury (P=0.424). We noted fractures of transverse processes in 7 cases, 6 of which showed vertebral artery injuries. Thus, the transverse process facture was associated with t vertebral artery injury (P=0.000). There seemed to be no relationship between the vertebral artery injury and each of following: fracture level (P=0.416), fracture type (P=0.723) and severity of soft tissue injury (P=0.195). Conclusions: Unilateral vertebral artery injuries were frequently found in the cervical spine fractures. And of all radiographic factors associated with vertebral artery injury, only the presence of transverse process fracture was statistically significant. Absence of signal void at multi-section MR images is considered to be a useful guide to commence additional vascular evaluation. Key Words: Vertebral artery injury, Cervical spine fracture, MRI

KEYWORDS

Vertebral artery injury, Cervical spine fracture, MRI

Citation status

* References for papers published after 2023 are currently being built.

[journal] Hayes P / 1980 / Cervical spine trauma: a cause of vertebral artery injury / J Trauma 20 : 904~905

[journal] CARPENTER S / 1961 / Injury of neck as cause of vertebral artery thrombos / J Neurosurg 18 : 849~853

[journal] Schippinger G / 1997 / Schweighofer F. Injury of the cervical spine associated with carotid and vertebral artery occlusion: case report and literature review / Injury 28 : 315~318

[journal] Cothren CC / 2003 / Cervical spine fracture patterns predictive of blunt vertebral artery injury / J Trauma 55 : 811~813

[journal] Biffl WL / 2000 / The devastating potential of blunt vertebral arterial injuries / Ann Surg 231 : 672~681

[journal] Cheatham ML / 1998 / Evaluation of acute mental status change in the nonhead injured trauma patient / Am Surg 64 : 900~905

[journal] Miller PR / 2001 / Blunt cerebrovascular injuries: diagnosis and treatment / J Trauma 51 : 279~286

[journal] Miller PR / 2002 / Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes / Ann Surg 236 : 386~393

[journal] Bok AP / 1996 / Carotid and vertebral artery occlusion after blunt cervical injury: the role of MR angiography in early diagnosis / J Trauma 40 : 968~972

[journal] Friedman D / 1995 / Vertebral artery injury after acute cervical spine trauma: rate of occurrence as detected by MR angiography and assessment of clinical consequences / AJR Am J Roentgenol 164 : 443~447

[journal] Taneichi H / 2005 / Traumatically induced vertebral artery occlusion associated with cervical spine injuries: prospective study using magnetic resonance angiography / Spine (Phila Pa 1976) 30 : 1955~1962

[journal] Vaccaro AR / 1998 / Long-term evaluation of vertebralartery injuries following cervical spine trauma using magnetic resonance angiography / Spine (Phila Pa 1976) 23 : 789~794

[journal] Heary RF / 1996 / Surgical anatomy of the vertebral arteries / Spine (Phila Pa 1976) 21 : 2074~2080

[journal] Schellinger PD / 2001 / Masking of vertebral artery dissection by severe trauma to the cervical spine / Spine (Phila Pa 1976) 26 : 314~319

[journal] Inamasu J / 2006 / Vertebral artery injury after blunt cervical trauma: an update / Surg Neurol 65 : 238~245

[journal] Deen HG Jr / 1992 / Vertebral artery injury associated with cervical spine fracture. Report of two cases / Spine (Phila Pa 1976) 17 : 230~234

[journal] Oetgen ME / 2008 / Does the morphology of foramen transversarium fractures predict vertebral artery injuries / Spine (Phila Pa 1976) 33 : 957~961

[journal] Parent AD / 1992 / Lateral cervical spine dislocation and vertebral artery injury / Neurosurgery 31 : 501~509

[journal] Woodring JH / 1993 / Transverse process fractures of the cervical vertebrae: are they insignificant / J Trauma 34 : 797~802

[journal] Louw JA / 1990 / Occlusion of the vertebral artery in cervical spine dislocations / J Bone Joint Surg Br 72 : 679~681

[journal] Veras LM / 2000 / Vertebral artery occlusion after acute cervical spine trauma / Spine (Phila Pa 1976) 25 : 1171~1177

[journal] Utter GH / 2006 / Sixteen-slice CT angiography in patients with suspected blunt carotid and vertebral artery injuries / J Am Coll Surg 203 : 838~848

[journal] Hiroshi T / 2005 / Traumatically induced vertebral artery occlusion associated with cervical spine injuries: prospective study using magnetic resonance angiography / Spine (Phila Pa 1976) 30 : 1955~1962

[journal] Weller SJ / 1999 / Detection of vertebral artery injury after cervical spine trauma using magnetic resonance angiography / J Trauma 46 : 660~666

KJCKorea
Journal Central

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03