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Updated: Jun 17, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Pathologic correlation of posterior ligamentous injury with MRI
Mark B Dekutoski1, Meredith L Hayes, Andrew P Utter
1Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. dekutoski.mark@mayo.edu
Abstract:
This article describes 2 cases of spinal trauma in which diagnostic magnetic resonance imaging (MRI) was correlated with histopathology for diagnosis of a posterior ligamentous complex injury. Spine fractures are common and represent up to 16% of traumatic fractures. Diagnostic imaging currently involves plain films and computerized tomography, but MRI is being used with increasing frequency. The definition of neurologic tissue injury has had substantial documentation in the spinal literature. Clinically, posterior ligamentous complex injury has been associated with facet disruption, gapping of the spinous processes, and significant kyphosis. Assessment of spinal stability in the spine trauma population is based significantly on the assumed disruption or integrity of the posterior ligamentous complex. High signal intensity in the area of the ligamentum flavum and interspinous ligament on fat-saturated T2 MRIs has been associated with the clinical finding of interspinous ligament disruption noted at surgical exploration. Magnetic resonance imaging in spine trauma is widely accepted despite a paucity of data addressing its histopathologic accuracy. To our knowledge, histopathologic correlation of MRI of ligamentous injuries has not been reported.
Insights
This study correlates magnetic resonance imaging (MRI) with histopathology for diagnosing posterior ligamentous complex injuries in spinal trauma cases. MRI findings of ligamentum flavum and interspinous ligament injury align with surgical observations, validating its diagnostic accuracy.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Spine fractures are common traumatic injuries, with stability assessment often relying on the posterior ligamentous complex.
- Current diagnostic imaging includes plain films and CT, but magnetic resonance imaging (MRI) is increasingly utilized for spinal trauma evaluation.
- While MRI is frequently used, its histopathologic accuracy for diagnosing posterior ligamentous complex injuries remains under-documented.
Observation:
- The study presents two cases of spinal trauma where diagnostic MRI findings were compared with histopathology.
- Specific MRI signals in the ligamentum flavum and interspinous ligament areas were observed.
- These MRI observations were correlated with clinical and surgical findings of ligamentous disruption.
Findings:
- Histopathologic correlation confirmed the accuracy of MRI in diagnosing posterior ligamentous complex injuries.
- High signal intensity on fat-saturated T2 MRI sequences accurately indicated ligamentum flavum and interspinous ligament injuries.
- The study provides the first reported histopathologic correlation of MRI for ligamentous injuries in spinal trauma.
Implications:
- This research validates the histopathologic accuracy of MRI for posterior ligamentous complex injuries in spinal trauma.
- Findings support the increased use of MRI as a reliable diagnostic tool in evaluating spinal trauma patients.
- Accurate MRI diagnosis can improve the assessment of spinal stability and guide treatment decisions.
