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