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Initial disc structural preservation in type A1 and A3 thoracolumbar fractures
P Loriaut1, G Mercy2, P E Moreau1
1Service de chirurgie orthopédique et de traumatologie, université Pierre-et-Marie-Curie, hôpital Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|October 24, 2015
Summary
Thoracolumbar fractures (Magerl type A) show no initial disc height loss or signal changes on MRI. Intervertebral discs in these injuries are generally intact, suggesting conservative management is appropriate.
Area of Science:
- Orthopedic Surgery
- Radiology
- Spine Trauma
Background:
- Optimal management of thoracolumbar fractures is debated.
- Disc lesions are often assumed in Magerl type A fractures.
Purpose of the Study:
- To assess intervertebral discs in Magerl type A thoracolumbar fractures at the time of trauma.
- To test the hypothesis of no initial change in disc shape and signal intensity.
Main Methods:
- Prospective study of 51 patients with 87 Magerl type A1 and A3 thoracolumbar fractures.
- MRI evaluation of disc signal, height, and morphology using Oner's classification.
Main Results:
- No signal intensity modification was observed on MRI.
- Disc morphology was normal or showed minor alterations; 98% were type 1 or 3.
- Mean initial disc height was 1.03 ± 0.36.
Conclusions:
- MRI revealed no loss of disc height or significant alteration in signal intensity and morphology.
- Intervertebral disc removal is not indicated for Magerl type A fractures.
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