Today: Dec 27, 2024
RU / EN
Last update: Dec 27, 2024
Diagnostic Imaging in Patients with Spinal Injury: an Optimized Procedure Based on Novel Technologies

Diagnostic Imaging in Patients with Spinal Injury: an Optimized Procedure Based on Novel Technologies

Bazhin A.V., Egorova E.A.
Key words: spine injuries; spinal trauma; polytrauma; spine X-ray; multislice computed tomography; magnetic resonance imaging.
2018, volume 10, issue 2, page 125.

Full text

html pdf
5326
2309

The aim of the study was to optimize the procedure of diagnostic imaging in patients suffering from spinal and spinal cord injuries by using novel technologies and modalities of diagnostic radiology.

Materials and Methods. Total of 105 patients with spinal cord injuries were included in the study. Of them, 32.4% of cases resulted from traffic accidents and 24.3% — from falls from heights >1 m with significant axial loading. The predominant injury components were compression (n=51, 48.5%) and flexure (n=25, 23.8%) lesions, and the rarest were extensor lesions (n=6), extensor lesions with disco-ligament tears caused by dislocations (n=5) or excessive stretching (n=3). Clinical and anamnestic data, neurological status (International Standards for Neurological Classification of Spinal Cord Injury, ASIA), and laboratory results were obtained. The imaging tests included spine X-ray and the novel radiology techniques — multislice computed tomography and magnetic resonance imaging.

Results. According to our findings, the examination protocol in patients with spine and spinal cord injuries should be based on the qualitative and quantitative characteristics of the lesions, the presence of neurological symptoms and signs of instability. In the cases of multiple multilevel and combined injuries of the spine and spinal cord and in the case of a severe patient’s condition, the immediate imaging approach should be limited to a spine X-ray test; upon patient’s stabilization, multislice computed tomography according to the “Polytrauma” (Whole body) protocol should be performed, including intravenous contrast enhancement. Magnetic resonance imaging should be performed in the early and late periods according to clinical indications.

  1. Krylov V.V., Grin’ A.A., Lutsik A.A., Parfenov V.E., Dulaev A.K., Manukovskii V.A., Konovalov N.A., Perl’mutter O.A., Safin Sh.M., Kravtsov M.N., Manashchuk V.I., Rerikh V.V. A protocol recommended for treating acute complicated and uncomplicated spinal injuries in adult patients (Association of Neurosurgeons of Russia). Part 1. Voprosy neirokhirurgii imeni N.N. Burdenko 2014; 78(6): 60–68, https://doi.org/10.17116/neiro201478660-67.
  2. Marinchek B., Dondelinger R.F. Neotlozhnaya radiologiya. Chast’ 1. [Emergency radiology. Vol. 1]. Moscow; VIDAR-М; 2008; 342 p.
  3. Cassar-Pullicino V.N., Imhof H. Spinal trauma — an imaging approach. Thieme; 2008; 256 p.
  4. Grinʼ А.А., Grigoreva Е.V. The radiology diagnostics of vertebral and spinal trauma. Part 1. Neirokhirurgiya 2012; 4: 8–16.
  5. Grinʼ А.А., Grigoreva Е.V. The radiology diagnostics of vertebral and spinal trauma. Part 2. Neirokhirurgiya 2013; 1: 7–21.
  6. Aganesov A.G. The future and the past of surgery for the complicated spine trauma. Khirurgiya. Zhurnal imeni N.I. Pirogova 2013; 1: 5–12.
  7. Schedrenok V.V., Yakovenko I.V., Moguchaya O.V., Orlov S.V., Anikeev N.V. Associative craniocerebral and vertebral-cerebrospinal trauma in cities with different number of population. Nevrologicheskiy vestnik. Zhurnal imeni V.M. Bekhtereva 2007; 2: 77–79.
  8. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 1983; 8(8): 817–831, https://doi.org/10.1097/00007632-198311000-00003.
  9. Saldun G.P. Zadniy kombinirovannyy spondilodez i ego mesto v operativnom lechenii tyazhelykh perelomov grudnogo i poyasnichnogo otdelov pozvonochnika. Dis. … kand. med. nauk [Rear combined spondylodesis and its place in the surgical treatment of severe fractures of the thoracic and lumbar spine. PhD Dissertation]. Leningrad; 1983.
  10. Magerl F., Aebi M., Gertzbein S.D., Harms J., Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 1994; 3(4): 184–201, https://doi.org/10.1007/bf02221591.
  11. Anderson L.D., Dʼalonzo R.T. Fractures of the odontoid process of the axis. J Bone Joint Surg Am 1974; 56(8): 1663–1674; https://doi.org/10.2106/00004623-197456080-00017.
  12. Patel A.A., Dailey A., Brodke D.S., Daubs M., Anderson P.A., Hurlbert R.J., Vaccaro A.R.; Spine Trauma Study Group. Subaxial cervical spine trauma classification: the Subaxial Injury Classification system and case examples. Neurosurg Focus 2008; 25(5): E8, https://doi.org/10.3171/foc.2008.25.11.e8.
  13. Andrei F.J., Michael D.D., Brandon D.L., Brodke D.S., Cendes F., Tedeschi H., Patel A.A. Retrospective evaluation of the validity of the Thoracolumbar Injury Classification System in 458 consecutively treated patients. Spine 2013; 13(12): 1760–1765, https://doi.org/10.1016/j.spinee.2013.03.014.
  14. Pfirrmann C.W., Dora C., Schmid M.R., Zanetti M., Hodler J., Boos N. MR image-based grading of lumbar nerve root compromise due to disk herniation: reliability study with surgical correlation. Radiology 2004; 230(2): 583–588, https://doi.org/10.1148/radiol.2302021289.
  15. Sedelnikov S.S., Dorovskikh G.N. Whole-body multidetector computed tomography as a stage of early diagnosis of polytrauma (review of literature and own experience). Radiologiya — praktika 2017; 5(65): 22–30.
  16. Dorovskikh G.N., Gorlina A.Yu. Radiologic evaluation and polytrauma treatment according to reports ATLS (review of the literature and own observations). Radiologiya — praktika 2017; 5: 73–81.
Bazhin A.V., Egorova E.A. Diagnostic Imaging in Patients with Spinal Injury: an Optimized Procedure Based on Novel Technologies. Sovremennye tehnologii v medicine 2018; 10(2): 125, https://doi.org/10.17691/stm2018.10.2.14


Journal in Databases

pubmed_logo.jpg

web_of_science.jpg

scopus.jpg

crossref.jpg

ebsco.jpg

embase.jpg

ulrich.jpg

cyberleninka.jpg

e-library.jpg

lan.jpg

ajd.jpg

SCImago Journal & Country Rank