Is there a way to diagnose spinal instability in acute burst fractures by performing ultrasound?
| Autor: | Michael J. Raschke, René Hartensuer, L. Löhrer, Thomas Vordemvenne, Volker Vieth, Thomas Fuchs |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Joint Instability Male Interspinous ligament medicine.medical_specialty Adolescent medicine.medical_treatment Sensitivity and Specificity Severity of Illness Index Thoracic Vertebrae Young Adult Burst fracture Predictive Value of Tests medicine Humans Posterior longitudinal ligament Orthopedics and Sports Medicine Prospective Studies Aged Ultrasonography Lumbar Vertebrae medicine.diagnostic_test business.industry Ultrasound Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Internal Fixators Longitudinal Ligaments Spinal Fusion Treatment Outcome medicine.anatomical_structure Spinal fusion Acute Disease Thoracic vertebrae Ligament Spinal Fractures Female Original Article Surgery Radiology business |
| Zdroj: | European Spine Journal. 18:964-971 |
| ISSN: | 1432-0932 0940-6719 |
| DOI: | 10.1007/s00586-009-1009-6 |
| Popis: | The aim of this study is to examine the predictive value of ultrasound diagnostics for the assessment of traumatic lesions of the posterior ligament complex (PLC) in burst fractures of the thoracolumbar spine. This was a prospective validating cohort study. Judgment about instability and treatment of burst fractures depends on the condition of the PLC. There have been some studies describing underdiagnosis of PLC injuries due to classification problems in ligamentary distraction type fractures. The gold standard for assessing these lesions is magnetic resonance imaging (MRI). Even then, there are often limits in contemporary operational availability and technical limitations of MRI. Ultrasound was described being an alternative. In a prospective study, 54 levels of 18 patients with acute burst fractures of the thoracic and lumbar spine have been examined by ultrasound and additional MRI scans preoperatively. The condition (intact vs. ruptured) of supraspinous ligament (SSL) and the interspinous ligament has been assessed for the ligaments separately. Hematoma below the SSL has also been evaluated as an indirect sign of an injured PLC. In all the patients the primary performed operative treatment was a posterior spinal instrumentation. Postoperatively the blinded results of the ultrasound procedures have been matched against intraoperative and MRI findings. Assessments of all target structures have been contributed to the calculation of the sensitivity and specificity of ultrasound. A total of 18 patients, 14 males and 4 females, with acute burst fractures have been qualified for inclusion in the study. The patients’ mean age was 43.4 years. Comparing intraoperative findings with preoperatively performed investigations, ultrasound archived a sensitivity of 0.99 and a specificity of 0.75 (P |
| Databáze: | OpenAIRE |
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