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Frank Hartmann,Thomas Nusselt,Stefan Mattyasovszky,Gerrit Maier,Pol Maria Rommens,Erol Gercek 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.1
Study Design: Retrospective study. Purpose: To evaluate radiological parameters as indicators for posterior ligamentous complex (PLC) injuries in the case of limited availability of magnetic resonance imaging. Overview of Literature: Traumatic thoracolumbar spinal fractures with PLC injuries can be misdiagnosed on X-rays or computed tomography scans. This study aimed to retrospectively assess unrecognized PLC injuries and evaluate radiographic parameters as indicators of PLC injuries requiring surgery. Methods: In total, 314 patients with type A and type B2 fractures who underwent surgical treatment between 2001 and 2010 were included. The frequency of misdiagnosis was reassessed, and radiographic parameters were evaluated and correlated. Results: The average age of the patients was 51.8 years. There were 225 type A3/A4 and 89 type B2 fractures; 39 of the type B2 fractures (43.8%) had been misdiagnosed as type A fractures. Type B fractures presented with a significantly higher kyphotic wedge angle and Cobb angle and a lower sagittal index (SI) than type A fractures. In addition, the normalized interspinous distance was higher in type B2 fractures. The significant mathematical indicators for PLC injuries were as follows: Cobb angle+kyphotic wedge angle >29°; Cobb angle2 >170°; and vertebral angle/SI >25. Conclusions: The results demonstrated that PLC injuries are frequently misdiagnosed. Correlations between certain radiological parameters associated with PLC injuries can be useful indicators of the presence of such injuries requiring surgery.
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