Computed tomography of spinal and pelvic fractures

The value of computed tomography (CT) compared with conventional x-ray was assessed in 29 spinal and 9 pelvic fractures. In the so called bursting fractures of spinal vertebrae the position of bone fragments in the neural canal was shown better by CT. The neural canal was remarkably narrowed on several occasions without the patient having any clinical symptoms of root or medullary compression. In 2 patients a fracture of laminae was discernible only on CT. Vertical fractures of vertebral bodies were also difficult to distinguish on the conventional plain x-ray. CT was helpful for planning of the anterolateral decompression operation of L2 in one patient. In cases of pelvic trauma sacro iliac joint diastasis was readily shown by CT. CT was clearly better able to determine whether the fracture extended across the sacro iliac joint. Also in fractures of the iliac wings CT readily showed the internal and external surfaces which were difficult to evaluate on plain radiographic examination. In spinal and pelvic fractures CT can give useful additional information which can influence the treatment of the trauma patient.