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MRI and discography in traumatic intervertebral disc lesions
Nadir Ghanem1, Markus Uhl, Christoph Müller
1Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. gha@mrs1.ukl.uni-freiburg.de
European Radiology
|June 16, 2006
Summary
Magnetic resonance imaging (MRI) effectively assesses adjacent disc injuries in trauma patients before spinal stabilization. This non-invasive technique provides superior preoperative information compared to discography, aiding surgical planning.
Area of Science:
- Orthopedics
- Radiology
- Spinal Surgery
Background:
- Vertebral fractures often involve adjacent intervertebral discs, impacting treatment decisions.
- Accurate assessment of adjacent disc injuries is crucial for effective spinal stabilization.
- Preoperative imaging plays a vital role in surgical planning for trauma patients.
Purpose of the Study:
- To evaluate the efficacy of magnetic resonance imaging (MRI) in assessing traumatized adjacent discs in trauma patients.
- To compare MRI findings with intraoperative discography for adjacent disc injury evaluation.
- To determine the utility of MRI in preoperative planning for dorsoventral spinal stabilization.
Main Methods:
- Prospective study involving 54 intervertebral discs in trauma patients.
- 1.5-T MRI with sagittal T1-weighted spin-echo (SE) and T2-weighted turbo spin-echo (TSE) sequences.
- Comparison of preoperative MRI findings with intraoperative discography.
Main Results:
- High concordance (87%) between MRI and discography for adjacent disc assessment.
- MRI identified traumatized adjacent discs in 22 cases and isolated cranial disc injuries in 7 cases.
- MRI revealed additional injuries including intradiscal bleeding (17), intraosseous herniations (13), annular tears (20), and ligament injuries (18).
Conclusions:
- MRI is a valuable non-invasive tool for assessing traumatized adjacent intervertebral discs in thoracolumbar spine fractures.
- MRI offers superior preoperative information compared to intraoperative discography for spinal trauma.
- Preoperative MRI is recommended for trauma patients undergoing dorsoventral stabilization to detect fractures, disc, and ligament injuries.
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