Radiographic Parameters in Diagnosis of Posterior Ligamentous Complex Injury

Background and Aim: Diagnosing the status of the posterior ligament complex (PLC) plays an essential role in the management of patients with thoracolumbar fractures. In this study, due to the inefficiency of existing imaging modalities in the accurate detection of PLC damage, we investigated the relevance of some imaging parameters to specific guidelines for rapid PLC injury detection. Methods and Materials/Patients: In this study, ۵۰ patients with and ۵۰ patients without PLC injury were included. MRI, CT scan, and radiographic imaging of the thoracolumbar spine (T۱۲-L۱) were evaluated. The thoracolumbar injury classification systems such as Denis, TLICS (Thoracolumbar Injury Classification and Scoring System), and McCormack Load Sharing and radiographic parameters such as Superior Inferior Endplate Angle (SIEA), Body Height (BH), Local Kyphosis (LK), Interspinous Distance (ISD), and Interpedicular Distance (IPD) were investigated in these patients for each imaging method. Statistical analysis was performed using SPSS (Version ۲۱). Result: The ISD and LK and BHp (Body Height Posterior) were significant predictors of PLC injury. On radiographs, the mean LK with and without PLC damage was ۲۵.۶۷° and ۲۰.۹۲°, respectively (p<۰.۰۰۱). The ISD difference was ۶.۷۵ mm in cases with PLC damage and ۲.۸۴ mm in cases with an intact PLC (p<۰.۰۰۰۱). In CT images, the mean LK was ۲۵.۷۷° in cases with PLC damage and ۱۸.۶۳° in cases with an intact PLC (p<۰.۰۳۷). The ISD difference was ۴.۱۴ mm in patients with PLC damage and ۲.۱۹ mm in patients without PLC damage (p<۰.۰۰۲). The BHp difference was ۹.۴۴ mm in cases with PLC damage and ۱۱.۰۹ mm in cases without PLC damage (p<۰.۰۰۲). Conclusion: The current study suggests formulating a predictive radiological index to identify PLC injury successfully. These guidelines can be very helpful in emergency room decision-makings, especially when the cost, availability, and time of performing MRI are important concerns in patients with multiple trauma.

کلیدواژه ها:

CT scan imaging ، posterior ligamentous complex ، thoracolumbar ، burst fracture