Can CT imaging of the chest, abdomen, and pelvis identify all vertebral injuries of the thoracolumbar spine without dedicated reformatting?

Am J Surg. 2018 Jul;216(1):52-55. doi: 10.1016/j.amjsurg.2017.12.001. Epub 2017 Dec 5.

Abstract

Background: The main objective of this study was to compare detection rates of clinically significant thoracolumbar spine (TLS) fracture between computed tomography (CT) imaging of the chest, abdomen, and spine (CT CAP) and CT for the thoracolumbar spine (CT TL).

Methods: We retrospectively identified patients at our institution with a TLS fracture over a two-year period that had both CT CAP and reformatted CT TL imaging. The sensitivity of CT CAP to identify fracture was calculated for each fracture type.

Results: A total of 516 TLS fractures were identified in 125 patients using reformatted CT TL spine imaging. Overall, 69 of 512 fractures (13%) were missed on CT CAP that were identified on CT TL. Of those, there were no clinically significant missed fractures.

Conclusions: CT CAP could potentially be used as a screening tool for clinically significant TLS injuries.

Keywords: CT; Reformat; Spine; Thoracolumbar; Trauma.

MeSH terms

  • Abdomen / diagnostic imaging*
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Pelvis / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Spinal Injuries / diagnosis*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries*
  • Thorax / diagnostic imaging*