Mauricio Gallardo-Guzmán1, Rubén Ríos-Téllez, Sergio Anaya-Vallejo. 1. Servicio de Columna, Hospital de Traumatología Victorio de la Fuente Narváez, UMAE Magdalena de las Salinas, Instituto Mexicano de Seguro Social, México, D.F., Mexico. neurocirujanazo@hotmail.com
Abstract
INTRODUCTION: The spinal fractures associated with posterior complex ligament injury are highly unstable, they require surgical stabilization and with frequency they can not do the diagnosis through imaging methods as radiography or computed tomography scan. Ultrasound is a no invasive imaging method that lets the visualization of the spinal posterior complex ligament and it also allows to see spinal fractures with or without ligament injury. OBJECTIVES: To correlate preoperative physical, radiographic and ultrasound findings with direct visualization of the posterior complex ligament, showing the diagnostic accuracy of the tests above mentioned regarding to detection of posterior complex ligament injury associated with thoracolumbar spinal fractures. MATERIAL AND METHODS: Fourteen patients with thoracolumbar fractures were evaluated by palpation of the interspinous gap, plain radiography and ultrasound before surgical treatment by a posterior approach. During the operation, posterior ligament complex injury was carefully examined. RESULTS: A wide interspinous gap was palpated in four patients and was found in 5 patients by radiography. Ultrasound examination showed ligament injury in 8 patients and integrity in 6. There was a significant relation between ultrasound findings and surgical results. CONCLUSION: Ultrasound is a highly sensitive and specific method to evaluate supraspinous and interspinous ligament injury in patients with thoracolumbar fractures, with superior diagnostic accuracy than physical exploration and radiographic evaluation.
INTRODUCTION: The spinal fractures associated with posterior complex ligament injury are highly unstable, they require surgical stabilization and with frequency they can not do the diagnosis through imaging methods as radiography or computed tomography scan. Ultrasound is a no invasive imaging method that lets the visualization of the spinal posterior complex ligament and it also allows to see spinal fractures with or without ligament injury. OBJECTIVES: To correlate preoperative physical, radiographic and ultrasound findings with direct visualization of the posterior complex ligament, showing the diagnostic accuracy of the tests above mentioned regarding to detection of posterior complex ligament injury associated with thoracolumbar spinal fractures. MATERIAL AND METHODS: Fourteen patients with thoracolumbar fractures were evaluated by palpation of the interspinous gap, plain radiography and ultrasound before surgical treatment by a posterior approach. During the operation, posterior ligament complex injury was carefully examined. RESULTS: A wide interspinous gap was palpated in four patients and was found in 5 patients by radiography. Ultrasound examination showed ligament injury in 8 patients and integrity in 6. There was a significant relation between ultrasound findings and surgical results. CONCLUSION: Ultrasound is a highly sensitive and specific method to evaluate supraspinous and interspinous ligament injury in patients with thoracolumbar fractures, with superior diagnostic accuracy than physical exploration and radiographic evaluation.