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[Early radiological assessment of spinal injuries. Indication for additional imaging procedures]
G Zöllner1, J L Dietemann, J C Dosch
1Service de Radiologie B, Hospices Civils de Strasbourg.
Unlabelled:
The question of the best radiological diagnostic pathway to explore the acute spinal trauma is discussed.
Method:
the current state of knowledge is given, based on bibliography and the authors experience.
Results:
Standard-radiography allows fast orientation. CT ist the best procedure for high resolution imaging of bony structures and MRI is best suited for soft tissue and medullar lesions. Ligamentous lesions are still explored with functional X-ray studies, but ligament rupture can be visualized directly by MRI.
Conclusions:
Standard-radiography must precede all further studies. In patients without neurological deficit: CT is indicated if standard radiography suspects a bony lesion. MRI is indicated, if there is a discrepancy between a normal radiography and severe complaints of the patient. functional radiographies are indicated if ligamentous damage is suspected, but MRI can directly visualize ligament rupture. In patients with a radicular lesion, CT is indicated. In patients with a medullar or central radicular lesion, MRI or Myelo-CT are indicated.