Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2005 Jun;12(2):140-145. Korean.
    Published online Jun 30, 2005.
    https://doi.org/10.4184/jkss.2005.12.2.140
    Copyright © 2005 Korean Society of Spine Surgery
    Original Article

    Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture

    Heui-Jeon Park, M.D., Phil-Eun Lee, M.D., Byung-Ho Lee, M.D. and Myung-Soon Kim, M.D.#
      • Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea.
      • #Department of Radiology, Yonsei University, Wonju College of Medicine, Wonju, Korea.
    • Address reprint requests to Heui-Jeon, Park, M.D. Department of orthopaedic Surgery, Wonju College of Medicine, Yonsei University, #162 Ilsan-dong, Wonju, Kangwon-do, Korea. Tel: 82-33-741-1352, Fax: 82-33-741-1358, Email: par73@wonju.yonsei.ac.kr

    Abstract

    Study Design

    A prospective study of 100 patients with thoracolumbar spinal fractures.

    Objectives

    To assess the relationships between a posterior ligament complex injury and plain radiograph in thoracolumbar spinal fractures.

    Summery of Literature Review

    Some studies have reported the value of MRI for the evaluation of a posterior ligament complex injury. However, most of these did not evaluate the relationships between the posterior ligament complex and plain radiograph of the thoracolumbar spine fractures.

    Materials and Methods

    100 patients with either a thoracolumbar compression or burst spinal fracture, from T11 to L2 levels, were evaluated by plain radiographs, taken in the supine position, and MRI taken within a week of the trauma. The wedge angle, Cobb's angle and anterior body height were measured on the plain radiographs, and the presence of posterior ligament complex injury on MRI was evaluated and analyzed.

    Results

    In the compression fracture group, the wedge angle, Cobb's angle and anterior body height loss were 19.9±1.4°, 14.3±2.2° and 35.6±3.6%, respectively, in the posterior ligament complex injury subgroup, but only the anterior vertebral body height loss was statistically significant (p=0.04). In the burst fracture group, the wedge angle, Cobb's angle and anterior body height loss were 26.4±2.0°, 23.3±1.7° and 57.4±5.2%, respectively, in the posterior ligament complex injury subgroup, which were all statistically significant (p=0.00, 0.02, 0.00). With a sensitivity of 75% or greater, the wedge angle, Cobb's angle and anterior body height loss in compression and burst fractures were more than 15°, 10° and 30% and 20°, 20° and 40%, respectively.

    Conclusions

    When the values of wedge angle, Cobb's angle and anterior body height loss in the compression and burst fractures were more than 15°, 10° and 30% and 20°, 20° and 40%, respectively, and the sensitivity for the presence of a posterior ligament complex injury was more than 75%. Therefore, these values in the screening test are indicators for the presence of a posterior ligament complex injury. Further careful evaluations, such as MRI, are still required in deciding the appropriate treatment method.

    Keywords
    Thoracolumbar spinal fracture; Posterior ligament complex; Magnetic Resonance Imaging; Plain radiograph

    Figures

    Fig. 1
    Measurement of Cobb's angle, Wedge angle and anterior body height. Q: Cobb's angle, W: wedge angle, A: anterior body height, Compression of anterior body =

    Fig. 2
    State of the ligamentous structures observed on the MRI examinations. (A) No evidence of injury. (B) Edema in the interspinous space without evident discontinuity or elongation (C) Elongation of the interspinous space without discontinuity (D) Clear disruption of the posterior ligamentous complex

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    MeSH Terms
    Body Height
    Fractures, Compression
    Humans
    Ligaments*
    Magnetic Resonance Imaging
    Mass Screening
    Prospective Studies
    Spinal Fractures*
    Spine
    Supine Position
    Metrics
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