The Pitfalls of Diagnosis and Treatment of Flexion Distraction Injuries of the Thoracic and Lumbar Spine: a Prospective Study

Česká verzia

Authors: L. Hrabálek ¹; J. Bučil ²; M. Vaverka ¹; M. Houdek ¹; D. Krahulík ¹; O. Kalita ¹
Authors place of work: Neurochirurgická klinika, LF UP a FN Olomouc ¹; Radiologická klinika, LF UP a FN Olomouc ²
Published in the journal: Cesk Slov Neurol N 2008; 71/104(2): 163-172
Category: Original Paper

Summary

The assessment of the degree of instability of an injured thoracic and lumbar spine is the basic prerequisite for choosing the adequate treatment procedure. That is the reason why so much emphasis is laid on precise imaging of the extent and location of damage caused to bone and ligament structures. Flexion distraction forms of injury render diagnosing based on normal skiagraphy and computer tomography rather difficult. An additional magnetic resonance imaging examination is a reliable method to detect loss of continuity of the posterior ligament complex. The authors evaluated 117 patients on a prospective basis of whom 14 (i.e. 12 %) had suffered a flexion distraction type of injury and had a high reliability record for magnetic resonance imaging examinations (100 %) in terms of evidence of posterior ligament complex injury, as compared with skiagraphy and computer tomography (71.4 %). Correct diagnosis is a result of a comprehensive assessment of all the above mentioned imaging methods and is the basis for the choice of adequate treatment. The choice of options for eventual surgery depends on the location and nature of spine injury. All surgeries for flexion distraction injuries in the studied group were sufficiently effective.

Key words:
injury – thoracic and lumbar spine – flexion distraction mechanism – spinal instability – magnetic resonance

Zdroje

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