[A comparison of plain film, axial CT, 2D and 3D reconstructions in unstable spinal injuries following surgery]

During a period of 18 months about 70 patients suffering from an unstable spinal injury were operated in the surgical department of our clinic. In 50 of these patients it was possible to correlate the results of preoperative radiography and CT with the operative findings. Several cases of distraction instability in the dorsal column had not been recognised in the preoperative radiologic evaluation. Therefore the rationale of this study was the question as to whether modern CT technology can help to avoid such wrong diagnoses. For that purpose radiographs, axial CT-scans of 2 mm thickness or less, sagittal and coronal 2D and (in 35 cases) 3D reconstructions were re-evaluated step by step by a specifically trained radiologist without knowing the operative findings. 15 additional lesions out of 28 were demonstrated and specifically classified as distraction instabilities of the dorsal column using the improved CT technology.