[Role of multislice spiral computed tomography in diagnosis of spinal injuries in polytrauma patients]

Spinal injury in poly trauma patients is serious problem, because they cause high mortality and morbidity. According to WHO statistics, there are registered 30 million cases of spinal injuries annually, 50% of them die before reaching the hospital. In last 5 years incidence of spinal traumas has increased 2.6 fold and is about one third of all spinal diseases. That is why spinal injuries remain a challenge. The purpose of our study is to assess diagnostic efficiency of multislice spiral CT in diagnosis of spinal injuries in poly trauma patients. We randomly assessed data from 200 poly trauma patients, who underwent multislice spiral CT in poly trauma mode. In 92 (46%) patients different types of spinal fractures and injuries were detected. Age distribution was 16-72 (mean age 52 years). Out of 92 patients, 9 (4.5%) had isolated trauma, 83 (41.5%) had multiple trauma. Solitary injury of spinal column was detected in 30 (32.6%) patients, 54 (58.6%) had combined spinal injuries. In spinal injury patients the most common trauma mechanism was MVC - 56 patients (60.86%), fall from height 27 (29.36%) patients, diving 5 (5.43%) patients, gun shot wound 3 (3.26%) patients, industrial injury 1 (1.08%) patients. The most common location of the injury was lumbar vertebra (55 patients), thoracic vertebra (39 patients), cervical vertebra (28 patients). After assessing MDCT and MRI results 37 patients were operated, 6 of them underwent surgical intervention urgently, 31 had delayed surgery, that was performed after treating other life threatening injuries. Indications for surgical intervention were spinal cord compression and non stable vertebral fractures. According to our study results, MDCT is the study of choice for the diagnosis of spinal injuries in poly trauma patients. It helps to detect type and extension of the bony injury and visualize fragments in the spinal canal. It is superior to other radiological studies. 3D, MIP and MPR reconstruction gives information about spatial location of the fracture and helps to timely plan correct management.