Journal List > J Korean Soc Spine Surg > v.12(3) > 1035663

Chang, Kim, Kim, Kwon, Seo, and Lee: Multiple Spine Fractures of Young Adult (Over 3 Vertebrae)

Abstract

Study Design

A retrospective study.

Objectives

To analyze the mode of injury, associated lesions, time of injury, and the checking times of MRI/CT and Bone scans in multiple spine fractures

Summary of Literature Review

CT was predominantly used to discover and identify the fracture levels of the spine. However, fracture level identification in the entire spine was limited. CT, MRI and Bone scans were used for diagnosing multiple spine fractures.

Materials and Methods

Between 1999 and 2004, 12 patients who had more than level 3 spine fractures were studied. The mode of injury, associated lesions, time of injury, and checking times of MRI/CT and Bone scans were analyzed.

Results

The causes of the spinal injuries were from a fall from height, from traffic accidents and from multi- complex forced trauma in 7, 4 and 1cases, respectively. Most cases had no severe associated lesions. The accuracy of the plain roentgenograms was 26% and that of CT was 35.3%, and the average checking time was 1.5 days. The accuracy of MRI was 100% and the average checking time was 4.3 days. The accuracy of the bone scans was 100%, and the average checking time was 11.7 days. The fracture patterns consisted of 37, 7, 3 and 3 non- compression (74%), compression (14%), burst (6%) and fracturedislocation types (6%), respectively. The major treatment methods used with these patients were conservative. The treatment methods in 4 cases were with the use posterior instrumentation.

Conclusions

MRI produced more accurate and faster results than the other methods of detection. The accuracy of the plain roentgenograms was 26%, which was relatively inaccurate. Therefore, if the patient complains of multiple back pains, the surgeon must check other diagnostic tools.

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Fig. 1.
T1 weighted sagittal MRI showing that spine of 15 year-old woman is noncontiguous 7 level fractures by traffic accidents.
jkss-12-206f1.tif
Fig. 2.
44 year-old man with noncontiguous 7 level fractures by fall from height.
jkss-12-206f2.tif
Table 1.
Summary of cases
Age Cause of injury Date of Dx Method of Dx Lesion site OP
45/M High energy HD # 4 MRI C6,7, T5,6,7,10,11 -
45/M Fall from 4m height HD # 3 MRI T12, L2, L4 -
43/F Fall from 4m height HD # 6 CT L1,L2, L4 -
22/F T.A. HD # 10 Bone scan C1,6, L2 -
19/F T.A. HD # 7 Bone scan T4,T6,T7,T9,T11,T12,L1 -
17/F Fall from 3th floor HD # 2 CT L1,L2,L3 +
44/M Fall from 2m height HD # 3 MRI T5,6,9,11,12, L1,3 +
45/M T.A. HD # 1 MRI T8,10, L2,4,5 -
34/M Fall from 2m height HD # 2 CT L1,L3,L4. +
30/M Fall from 3m height HD # 1 X-ray T12,L1,L2 -
59/M T.A. HD # 29 Bone scan T11, L2,L3 +
37/M Fall from 3m height HD # 1 X-ray L1,L2, L3 -

M, Male; F, Famale; T.A., Traffic accident; HD, Hospital Day.

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