PURPOSE: To reassess the diagnostic value of plain radiographs, compared with computed tomography, in thediagnosis of acute traumatic spinal fracture. MATERIALS AND METHODS: Forty-six patients (total 64 cases) withacute traumatic spinal fracture were studied using plain radiographs and computed tomography. Fracture site andtype (according to the three-column theory), classification as major or minor injury, stability of fracture, andthe presence of associated soft tissue change were evaluated on plain radiographs and CT. The results of the twoimaging techniques were compared. RESULTS: Excluding eight cases of C1 and C2 fractures, 41 cases involvedfractures of the vertebral body, and 15 involved only the posterior column. Plain radiographs and CT showed,respectively, 27 and 25 cases of simple compression fracture, 13 and 16 of bursting fracture. One case ofcompression fracture was not detected on plain radiographs. The results of classification as major (43/56) orminor (13/56) injury were equivalent on plain and CT films. For the evalvation of unstable fracture, plainradiographs were superior to CT(stable fracture, 46/64; unstable fracture, 18/64), while for the evaluation ofsoft tissue change, CT was better than plain radiographs. CONCLUSION: If correct procedures are meticulouslyadhered to, plain radiographs of acute traumatic spinal injury provide good information for the diagnosis oftraumatic fracture.
Classification ; Diagnosis ; Fractures, Compression ; Humans ; Spinal Fractures* ; Spinal Injuries

The accurate diagnosis of spine trauma is essential to its proper management, since therapeutic decisionsdepend on radiography and clinical data. Failure to recognize significant injury to the spine can lead to severeneurological deficit in the previously neulogically intact patient. The developmemt of CT has open a new demensionin evaluation of spinal column. In our experience CT not only offer the accurate and thorough evaluation of spinalinjury, but does so in a rapid and more efficient manner when compared with conventional radiolgraphy. CT hasbecome the diagnostic procedure of choice when screening plain film and clinical examination indecate that acomprehensive radiographic evaluation is necessary. Eighteen patients with thoracic and lumber spinal fracturewere studied with CT. Four had multiple level injuries. The resuls are summerized as follow; 1. Among the 18patients, 4 had multiple level injuries and other 14 patients had single spinal injury. 2. 8 patients (11 spines)had simple compression fracture and 12 patients (13 spines) had burst fracture of vertebral body. 3. 15 spinesamong the 24 involved spines are located at T12 and L1 level. 4. Spineal canal narrowing and bony fragment in thecanal are defiend only 7 of 13 spines (53.8%) of burst fracture in conventional radiography. However CT showed inall spines of burst fracture. 5. Spinal posterior element involvement is suggested only one of 12 spines of burstfracture, but correctly interpretated by CT in 7 spines(11 anatomical position).
Diagnosis ; Fractures, Compression ; Humans ; Mass Screening ; Radiography ; Spinal Fractures ; Spinal Injuries ; Spine

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the diagnosis of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Conventional modalities including simple radiographs, bone mineral density (BMD) tests, and bone scans are sufficient for diagnosis of OSFs. However, other clinical and radiographic clues should be considered for prediction of the prognosis and differential diagnosis. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: Clinical clues including morphometric changes in the vertebral body are sufficient for diagnosis of OSFs. BMD testing is helpful for diagnosis of osteoporosis. However, simple radiographs and BMD tests do not present sufficient information on the prognosis of OSFs. The location of the involved segments, morphological characteristics, and other co-morbidities should be taken into consideration in the initial management of OSFs. Moreover, pathologic conditions leading to spinal fractures should be taken into account in some clinical situations. CONCLUSIONS: With increasing reports of complicated OSFs or other pathologic fractures, other diagnostic modalities and clinical factors should be considered in predicting the prognosis of OSFs and differentiating OSFs from other pathologic conditions.
Bone Density ; Diagnosis* ; Diagnosis, Differential ; Fractures, Spontaneous ; Osteoporosis ; Prognosis ; Spinal Fractures*

Adult ; Bartter Syndrome ; complications ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Osteoporotic Fractures ; etiology ; Spinal Fractures ; etiology

Humans ; Spinal Fractures ; classification ; diagnosis ; therapy ; Thoracic Vertebrae ; injuries ; surgery

STUDY DESIGN: The study retrospectively investigated 15 cases with multilevel noncontiguous spinal fractures (MNSF). PURPOSE: To clarify the evaluation of true diagnosis and to plane the surgical treatment. OVERVIEW OF LITERATURE: MNSF are defined as fractures of the vertebral column at more than one level. High-energy injuries caused MNSF, with an incidence ranging from 1.6% to 16.7%. MNSF may be misdiagnosed due to lack of detailed neurological and radiological examinations. METHODS: Patients with metabolic, rheumatologic diseases and neoplasms were excluded. Despite the presence of a spinal fracture associated clearly with the clinical picture, all patients were scanned within spinal column by direct X-rays, computed tomography and magnetic resonance imaging. When there were > or =5 intact vertebrae between two fractured vertebral segments, each fracture region was managed with a separated stabilization. In cases with < or =4 intact segments between two fractured levels, both fractures were fixed with the same rod and screw system. RESULTS: There were 32 vertebra fractures in 15 patients. Eleven (73.3%) patients were male and age ranged from 20 to 64 years (35.9+/-13.7 years). Eleven cases were the American Spinal Injury Association (ASIA) E, 3 were ASIA A, and one was ASIA D. Ten of the 15 (66.7%) patients returned to previous social status without additional deficit or morbidity. The remaining 5 (33.3%) patients had mild or moderate improvement after surgery. CONCLUSIONS: The spinal column should always be scanned to rule out a secondary or tertiary vertebra fracture in vertebral fractures associated with high-energy trauma. In MNSF, each fracture should be separately evaluated for decision of surgery and planned approach needs particular care. In MNSF with < or =4 intact vertebra in between, stabilization of one segment should prompt the involvement of the secondary fracture into the system.
Asia ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Fractures* ; Spinal Injuries ; Spine

More than one third of patients may present with bone pain as a consequence of leukemic cell infiltration of bone, however, bone fracture itself is an unusual presentation for childhood acute lymphoblastic leukemia (ALL). Back pain by vertebral fracture is a rare initial presentation of childhood ALL. If back pain due to vertebral fracture is the only clinical manifestation of ALL without any other accompanying symptoms, signs, or hematologic abnormality, the diagnosis of ALL could be delayed. To promote greater awareness that vertebral facture caused by ALL, resulting in significant back pain without other systemic symptoms, we report on the case of an 8-year-old boy who complained only of back pain which occurred about one month prior to visit and who was later diagnosed with ALL.
Back Pain ; Child ; Diagnosis ; Fractures, Bone ; Fractures, Compression ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Spinal Fractures

OBJECTIVES: To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. METHODS: Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. RESULTS: Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. CONCLUSIONS Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury.
Accidents, Traffic ; Acetabulum/injuries* ; Death ; Forensic Pathology ; Fractures, Bone/diagnosis* ; Fractures, Comminuted/diagnosis* ; Humans ; Ischium/injuries* ; Pelvic Bones/injuries* ; Soft Tissue Injuries/diagnosis* ; Spinal Fractures/diagnosis*

Humans ; Poliomyelitis/diagnosis* ; Fractures, Bone ; Lower Extremity ; Spinal Cord Injuries/diagnosis*

The characteristic pathological lesions in ankylosing spondylitis are vertebral body osteoporosis, ankylosis of the apophyseal joints, intervertebral disc calcification, and ligamentous ossification. Calcification of the annulus fibrosis reduces the movement and elasticity of the intervertebral disc, causing this point to be the site of least resistance when the spine is subjected to trauma. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. The ligamentous fragility and multiple fused vertebral segments cause the fractured ankylosing spondylitic spine to resemble a long-bone fracture. In ankylosing spondylitis patient who have sustained minor trauma, a complete radiological study of the entire spine and not just the symptomatic region must be performed for an accurate diagnosis, so that any fracture possible along the spine can be detected and thus prevent any medicolegal problems. The authors report 4 cases of ankylosing spondylitis including 2 cases with severe neurological abnormalities that had occurred after minor trauma.
Ankylosis ; Diagnosis ; Elasticity ; Fibrosis ; Humans ; Intervertebral Disc ; Joints ; Ligaments ; Osteoporosis ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*