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Acute spinal ligament disruption: MR imaging with anatomic correlation

M A Kliewer1, L Gray, J Paver

  • 1Department of Radiology, Duke University Medical Center, Durham, NC 27710.

Journal of Magnetic Resonance Imaging : JMRI
|November 1, 1993
PubMed
Summary
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Magnetic resonance (MR) imaging shows promise for detecting spinal ligament injuries. This study found MR imaging accurately identified 79% of ligament tears in cadaveric spines, aiding in assessing spinal instability.

Area of Science:

  • Orthopedics
  • Radiology
  • Biomechanics

Background:

  • Spinal ligament disruption can cause instability, endangering the spinal cord and nerve roots.
  • Direct imaging of spinal ligaments is possible with Magnetic Resonance (MR) imaging.
  • The sensitivity of MR imaging for detecting ligament injuries has not been previously reported.

Purpose of the Study:

  • To evaluate the sensitivity of MR imaging in detecting spinal ligament disruptions.
  • To compare MR imaging with plain radiography and computed tomography for identifying ligament tears.

Main Methods:

  • Twenty-eight cadaveric spines were subjected to controlled injuries causing ligament tears.
  • Spines were imaged using plain radiography, computed tomography, and 1.5 T MR imaging.

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  • Images were analyzed for ligament injury evidence before specimen dissection.

    • Main Results:

    • MR imaging correctly identified 41 of 52 (79%) ligament tears.
    • Anterior and posterior longitudinal ligament disruptions were detected in all cases (100% sensitivity).
    • Ligamentum flavum, capsular, and interspinous ligament tears were identified less reliably, with 3 false-positives and 11 false-negatives.

    Conclusions:

    • MR imaging can reliably assess spinal ligament disruption in an in vitro model.
    • This suggests potential clinical utility for MR imaging in diagnosing spinal ligament injuries.
    • Further research is warranted to confirm these findings in patient populations.