• World Neurosurg · Sep 2021

    Diagnostic value of various morphological features of horizontal and vertical laminar fractures for posterior ligamentous complex injury of the thoracolumbar spine as defined by MRI.

    • Mohamed M Aly, Abdulbaset M Al-Shoaibi, Areej Al Fattani, and Ali Hassan AlJuzair.
    • Department of Neurosurgery, Mansoura University, Mansoura, Egypt; Department of Neurosurgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia. Electronic address: drmoali26@gmail.com.
    • World Neurosurg. 2021 Sep 1; 153: e290-e299.

    ObjectiveTo determine diagnostic value of morphological features of horizontal laminar fracture (HLF) and vertical laminar fracture (VLF) for diagnosis of posterior ligamentous complex (PLC) injury.MethodsThis retrospective review comprised 271 consecutive patients with acute thoracolumbar fractures presenting to a Level 1 trauma center between January 2014 and January 2021. Two reviewers evaluated computed tomography and magnetic resonance imaging. VLFs were subclassified based on length and depth of lamina involved, as follows: type 1, full-length complete; type 2, full-length incomplete; type 3, partial-length complete or incomplete. HLFs were subclassified as follows: bilateral versus unilateral, displaced >2 mm versus nondisplaced, and lamina-only versus laminar and pedicle. We examined the diagnostic accuracy and the univariate and multivariate associations of laminar fracture subtypes with PLC injury as defined by black stripe discontinuity.ResultsBilateral HLFs, laminar and pedicle fractures, displaced HLFs, and type 1 VLFs yielded a high positive predictive value for PLC injury (95%, 91%, 100%, and 86%, respectively). Type 2 and 3 VLFs did not show significant univariate associations with PLC injury. Bilateral HLFs, laminar and pedicle fractures, and displaced HLFs showed independent associations with PLC injury (adjusted odds ratio = 13.6, 8.4, 6, and 10.3, respectively; P < 0.002). Type 1 VLFs did not show a significant association with PLC (adjusted odds ratio = 10.3; P = 0.06).ConclusionsBilateral HLFs, laminar and pedicle fractures, and displaced HLFs, but not any VLF subtypes, were independently associated with PLC injury. These findings may improve the reliability of PLC assessment by computed tomography.Copyright © 2021 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…