• Sebastian Winklhofer, Merly Thekkumthala-Sommer, Diethard Schmidt, Kaspar Rufibach, Clément M L Werner, Guido A Wanner, Hatem Alkadhi, Jürg Hodler, and Gustav Andreisek.
• Institute for Diagnostic and Interventional Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
• Skeletal Radiol. 2013 Jun 1; 42 (6): 779-86.

ObjectiveTo evaluate the influence of additional (MRI) compared with computed tomography (CT) alone for the classification of traumatic spinal injuries using the Arbeitsgemeinshaft für Osteosynthesefragen (AO) system and the Thoraco-Lumbar Injury Classification and Severity (TLICS) scale.Materials And MethodsImages from 100 consecutive patients with at least one fracture on CT were evaluated retrospectively by three radiologists with regard to the AO and TLICS classification systems in 2 steps. First, all images from the initial CT examination were analyzed. Second, 6 weeks later, CT and MR images were analyzed together. Descriptive statistics and Wilcoxon tests were performed to identify changes in the number of fractures and ligamentous lesions detected and their corresponding classification.ResultsCT and MRI together revealed a total of 196 fractures (CT alone 162 fractures). The AO classification changed in 31 %, the TLICS classification changed in 33 % of the patients compared with CT alone. Based on CT and MRI together, the TLICS value changed from values <5 (indication for conservative therapy) to values ≥ 5 (indication for surgical therapy) in 24 %.ConclusionMRI of patients with thoracolumbar spinal trauma considerably improved the detection of fractures and soft tissue injuries compared with CT alone and significantly changed the overall trauma classification.

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