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Abstract
Objective
To define the clinical and radiological characteristics of the patients with injury of the posterior ligament complex of the cervical spine using MR imaging.
Materials and Methods
Forty patients with acute cervical spine fracture who underwent surgery were examined with MR imaging and plain radiography. Twenty- five patients underwent posterior fusion. The MR findings were correlated with surgical findings, clinical findings, and plain radiographs.
Results
Posterior ligament complex injury was detected in 75% (n=30) of all patients. Of the 20 patients with distractive- flex-ion injury, 90%(n=18) had posterior ligament complex injury (p<0.05). Of the 15 patients with compressive- flexion injury, 73%(n=11) had ligament injury. Of the 4 patients with vertical compression injury, 1 patient (25%) showed ligament injury. One patient with distractive- extension injury did not show ligament injury. Of the 23 patients with complete spinal cord injury, 96%(n=22) showed ligament tear (p<0.05). Of the 17 patients without complete cord injury (15 incomplete injury, 2 no cord injury),47% (n=8) had ligament injury. Surgical findings were well correlated with MR imaging in patients who underwent posterior surgery (p<0.05).
REFERENCES
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Table 1.
Types and Number of Fractures by Allen Classification in Patients with and without PLC injury (p<0.05)
| Type | No. of cases | PLC∗ injury | |
|---|---|---|---|
| (+)(%) | (-) | ||
| Distractive flexion | 20 | 18(90) | 2 |
| Compressive flexion | 15 | 11(73) | 4 |
| Vertical compression | 24 | 11(25) | 3 |
| Distractive extension | 21 | 10(10) | 1 |
Table 2.
Relation of number of cases between posterior ligament complex injury and spinal cord injury (p<0.05)
| Cord injury | Posterior ligament Complex injury | |
|---|---|---|
| (+) | (-) | |
| Complete | 22 | 1 |
| Incomplete | 8 | 9 |
Table 3.
Accuracy of MRI in detecting posterior ligament complex injury
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