Thoracolumbar burst fractures: evaluation with MR imaging

Area of Science:

• Orthopedic Surgery
• Radiology
• Spinal Trauma

Background:

• Thoracolumbar burst fractures often involve posterior ligamentous complex injuries.
• Accurate assessment of ligamentous integrity is crucial for treatment decisions.

Purpose of the Study:

• To determine the frequency of posterior ligamentous injury in thoracolumbar burst fractures.
• To correlate ligamentous disruption with radiographic findings.

Main Methods:

• Retrospective review of MR imaging for ligament integrity in 25 thoracolumbar burst fractures.
• Evaluation of radiographic and CT scans for specific fracture characteristics.
• Correlation of imaging findings with ligament status.

Main Results:

• Supraspinous ligament (SSL) disruption occurred in 6 of 21 patients.
• No correlation was found between radiographic/CT findings and SSL disruption.
• Radiographic signs of posterior ligamentous disruption were insensitive, present in only 33% of patients with SSL disruption.

Conclusions:

• Supraspinous ligament disruption is frequent in thoracolumbar burst fractures.
• Radiographic features do not reliably predict SSL disruption.
• Radiographic assessment of posterior ligamentous integrity is not sensitive.