To evaluate the usefulness of plain lateral radiographs processed by the Wintopo® program (SoftSoft.net™, version 1.11, USA)for a picture archiving communication system (PACS) for the diagnosis of bursting fracture.

From January 2001 to April 2002, 24 cases of thoracic and lumbar spine fractures with available computed tomographs were evaluated. Lateral plain radiographs were reviewed by five orthopedic residents, and then were saved as bmp files in a picture archiving communication system. The borderline posterior body in the lateral plain radiographs was defined using the vector image in the Wintopo® program. After processing, radiographs were re-evaluated.

In all participants, the sensitivity of the diagnosis of bursting fracture was significantly improved after Wintopo® program processing. Although the specificity and positive predictive value were improved by processing, this was not statistically significant.

Wintopo® program processing of plain lateral radiographs of the spine could improve the sensitivity of diagnosis for bursting fracture in acute spinal injury.