Injuries to the Rigid Spine: What the Spine Surgeon Wants to Know
| Autor: | Christopher M. Bono, Diego B. Nunez, Abhishek R. Keraliya, Nandish G. Shah, Andrew J. Schoenfeld, Mitchel B. Harris, Bharti Khurana |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Adult Male Hyperostosis medicine.medical_specialty Delayed Diagnosis Population 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Epidural hematoma medicine Back pain Humans Radiology Nuclear Medicine and imaging Spondylitis Ankylosing education Spinal cord injury Spondylitis Diffuse Idiopathic Skeletal Hyperostosis Aged Ankylosing spondylitis education.field_of_study Hyperostosis Diffuse Idiopathic Skeletal business.industry Middle Aged musculoskeletal system medicine.disease Magnetic Resonance Imaging Spine Spinal Fusion Spinal Injuries 030220 oncology & carcinogenesis Spinal Fractures Female Radiology Spondylosis medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | Radiographics : a review publication of the Radiological Society of North America, Inc. 39(2) |
| ISSN: | 1527-1323 |
| Popis: | The biomechanical stability of the spine is altered in patients with a rigid spine, rendering it vulnerable to fracture even from relatively minor impact. The rigid spine entities are ankylosing spondylitis (AS), diffuse idiopathic skeletal hyperostosis, degenerative spondylosis, and a surgically fused spine. The most common mechanism of injury resulting in fracture is hyperextension, which often leads to unstable injury in patients with a rigid spine per the recent AOSpine classification system. Due to the increased risk of spinal fractures in this population, performing a spine CT is the first step when a patient with a rigid spine presents with new back pain or suspected spinal trauma. In addition, there should be a low threshold for performing a non-contrast-enhanced spine MRI in patients with a rigid spine, especially those with AS who may have an occult fracture, epidural hematoma, or spinal cord injury. Unfortunately, owing to insufficient imaging and an unfamiliarity with fracture patterns in the setting of a rigid spine, fracture diagnosis is often delayed, leading to significant morbidity and even death. The radiologist's role is to recognize the imaging features of a rigid spine, identify any fractures at CT and MRI, and fully characterize the extent of injury. Reasons for surgical intervention include neurologic deficit or concern for deterioration, an unstable fracture, or the presence of an epidural hematoma. By understanding the imaging features of various rigid spine conditions and vigilantly examining images for occult fractures, the radiologist can avoid a missed or delayed diagnosis of an injured rigid spine. ©RSNA, 2019. |
| Databáze: | OpenAIRE |
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