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Dural lacerations and thoracolumbar fractures
1Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 37232.
Journal of Spinal Disorders
|June 1, 1989
Summary
Dural lacerations are common in thoracolumbar burst fractures, particularly with posterior element fractures and motor deficits. CT scans help predict these injuries, which are significant in surgical cases.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Radiology
Background:
- Dural lacerations (DL) associated with thoracolumbar fractures were previously identified via plain radiography.
- Computed tomography (CT) has improved the characterization of these injuries.
Purpose of the Study:
- To evaluate the predictive value of CT for detecting dural lacerations in thoracolumbar burst fractures.
- To determine the clinical significance of dural lacerations in this patient population.
Main Methods:
- Retrospective review of 25 patients with 27 thoracolumbar burst fractures.
- Assessment of CT findings, including posterior element fractures and spinal canal compromise.
- Correlation of dural lacerations with motor neurologic deficits.
Main Results:
- Dural lacerations were identified in 32% of cases (8 out of 25 patients).
- DLs were significantly associated with posterior element fractures on axial CT and motor deficits.
- No correlation was found between DL presence and the degree of spinal canal compromise.
Conclusions:
- Dural lacerations are frequent in thoracolumbar fractures requiring surgery.
- CT is valuable for predicting DLs, especially when motor deficits and posterior element fractures are present.
- Identifying DLs is crucial for surgical management planning.