Measurement of Canal Encroachment Using Axial and Sagittal-Reconstructed Computed Tomographic Images in Thoracolumbar Burst Fractures (축상 및 시상면 재건 전산화 단층촬영 영상을 이용한 흉요추부 방출성 골절의 척추강내 골편 감입 측정)

Kim Jim Ho (김진호); 전창훈; 정남수; Lim Oh Kyung (임오경); 노형래

Measurement of Canal Encroachment Using Axial and Sagittal-Reconstructed Computed Tomographic Images in Thoracolumbar Burst Fractures

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2011, 18(3), pp.111-116
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

Kim Jim Ho ¹, 전창훈 ¹, 정남수 ¹, Lim Oh Kyung ², 노형래 ¹

¹아주대학교
²가천대학교

Accredited

ABSTRACT

Study Design: A retrospective study. Objectives: The aim of this study was to examine the usefulness of axial and sagittal-reconstructed CT images in the evaluation of spinal canal encroachment by thoracolumbar burst fractures. Summary of Literature Review: The dimensions of spinal canal encroachment by burst fractures have been described using axial CT images in the thoracolumbar region and sagittal-reconstructed images in the lower cervical region. However, the validity and reliability,depending on the measuring method, have not been fully evaluated. Materials and Methods: A hundred and ninety-nine patients, who had diagnosed as a thoracolumbar burst fracture, were included in this study. Three orthopedic surgeons independently measured the canal encroachment of the burst fragment in the axial CT images and the sagittal-reconstructed images using the ratio of spinal length (method 1) and the ratio of area (method 2). The validity for the evaluation of the deformity and fracture stability was evaluated. In addition, the reliability of each method was assessed. Results: Sixty-seven stable burst fractures and 132 unstable burst fractures were assessed. The mean kyphotic angle of stable and unstable burst fracture were 11.89 ± 8.49°and 15.90 ± 9.63°(P=0.005). The mean canal encroachment ratios of stable fracture were 17.21 ± 15.82 % (axial-method 1), 16.71 ±16.49 % (axial-method 2), 19.54 ± 17.03 % (sagittal reconstructed-method 1), and 11.75 ± 12.33% (sagittal reconstructed-method 2). The mean canal encroachment ratios of unstable fracture were 31.54 ± 17.10 % (axial-method 1), 29.67 ± 18.47 % (axial-method 2), 28.53 ± 18.60 % (sagittal reconstructed-method 1), and 21.20 ± 15.11 % (sagittal reconstructedmethod 2). There was no relationship between the fracture deformity and the canal encroachment ratio in all 4 methods. All ratios in the 4 method showed significant differences in the evaluation of fracture stability. All methods except method 1 in the sagittal-reconstructed images showed significant differences in the assessment of neurologic compromise. Conclusions: The measurement of a canal encroachment area using axial and sagittal-reconstructed images was valid in the description of fracture stability. Key Words: Thoracolumbar, Burst fracture, Canal encroachment, Computed tomography

KEYWORDS

Thoracolumbar, Burst fracture, Canal encroachment, Computed tomography

Citation status

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

[journal] Denis F / 1983 / The three column spine and its significance in the classification of acute thoracolumbar spinal injuries / Spine (Phila Pa 1976) 8 : 817~831

[journal] McAfee PC / 1983 / The value of computed tomography in thoracolumbar fractures. An analysis of one hundred consecutive cases and a new classification / J Bone Joint Surg Am 65 : 461~473

[journal] Vaccaro AR / 2001 / The significance of thoracolumbar spinal canal size in spinal cord injury patients / Spine (Phila Pa 1976) 26 : 371~376

[journal] Dai LY / 2007 / Neurologic recovery from thoracolumbar burst fractures: is it predicted by the amount of initial canal encroachment and kyphotic deformity / Surg Neurol 67 : 232~237

[journal] Meves R / 2005 / Correlation between neurological deficit and spinal canal compromise in 198 patients with thoracolumbar and lumbar fractures / Spine (Phila Pa 1976) 30 : 787~791

[journal] Dall BE / 1988 / Neurologic injury and recovery patterns in burst fractures at the T12 or L1 motion segment / Clin Orthop Relat Res : 171~176

[journal] Eberl R / 2003 / Importance of the cross-sectional area of the spinal canal in thoracolumbar and lumbar fractures. Is there any correlation between the degree of stenosis and neurological deficit / Orthopade 32 : 859~864

[journal] Herndon WA / 1988 / Neurologic return versus cross-sectional canal area in incomplete thoracolumbar spinal cord injuries / J Trauma 28 : 680~683

[journal] Keene JS / 1989 / Significance of acute posttraumatic bony encroachment of the neural canal / Spine (Phila Pa 1976) 14 : 799~802

[journal] Mohanty SP / 2002 / Does neurological recovery in thoracolumbar and lumbar burst fractures depend on the extent of canal compromise / Spinal Cord 40 : 295~299

[journal] Zhao X / 2010 / Traumatic canal stenosis should not be an indication for surgical decompression in thoracolumbar burst fracture / Med Hypotheses 75 : 550~552

[journal] Bono CM / 2006 / Measurement techniques for lower cervical spine injuries: consensus statement of the Spine Trauma Study Group / Spine (Phila Pa 1976) 31 : 603~609

[journal] Keynan O / 2006 / Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group / Spine (Phila Pa 1976) 31 : 156~165

[journal] Tran NT / 1995 / Anderson PA. Mechanism of the burst fracture in the thoracolumbar spine. The effect of loading rate / Spine (Phila Pa 1976) 20 : 1984~1988

[journal] Willen J / 1985 / Unstable thoracolumbar fractures. A comparative clinical study of conservative treatment and Harrington instrumentation / Spine (Phila Pa 1976) 10 : 111~122

[journal] Krompinger WJ / 1986 / Conservative treatment of fractures of the thoracic and lumbar spine / Orthop Clin North Am 17 : 161~170

[journal] Gertzbein SD / 1992 / Scoliosis Research Society. Multicenter spine fracture study / Spine (Phila Pa 1976) 17 : 582~40

[journal] Petersilge CA / 1995 / Thoracolumbar burst fractures: evaluation with MR imaging / Radiology 194 : 49~54

[journal] Oner FC / 2002 / Some complications of common treatment schemes of thoracolumbar spine fractures can be predicted with magnetic resonance imaging: prospective study of 53 patients with 71 fractures / Spine (Phila Pa 1976) 27 : 629~636

[journal] Haba H / 2003 / Diagnostic accuracyof magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures / J Neurosurg 99 : 20~26

[journal] Oner FC / 1999 / MRI findings of thoracolumbar spine fractures: a categorisation based on MRI examinations of 100 fractures / Skeletal Radiol 28 : 433~443

[journal] Vaccaro AR / 2005 / The thoracolumbar injury severity score: a proposed treatment algorithm / J Spinal Disord Tech 18 : 209~215

[journal] Vaccaro AR / 2006 / Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score / Spine (Phila Pa 1976) 31(11 Suppl) : 62~69

[journal] Meves R / 2006 / Correlation among canal compromise, neurologic deficit, and injury severity in thoracolumbar burst fractures / Spine (Phila Pa 1976) 31 : 2137~2141

KJCKorea
Journal Central

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