K J Schnake1, F von Scotti, N P Haas, F Kandziora. 1. Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland. klaus.schnake@bgu-frankfurt.de
Abstract
BACKGROUND: Type B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries. MATERIALS AND METHODS: Retrospective study evaluating 361 fractures. RESULTS: Initially, 39 (41.9%) of 93 type B injuries were misdiagnosed as type A. 59% of 93 injuries belonged in the type B1 category. 29% of these showed no radiological signs of a PLC injury. Among the remaining cases, the following signs were the most frequently seen: vertebral segmental angle >15 degrees (44%), pronounced compression of vertebral cancellous bone despite minimal (<50%) reduced anterior vertebral height (41%), and a considerably reduced anterior vertebral height to <50% (31%). CONCLUSION: Type B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.
BACKGROUND: Type B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries. MATERIALS AND METHODS: Retrospective study evaluating 361 fractures. RESULTS: Initially, 39 (41.9%) of 93 type B injuries were misdiagnosed as type A. 59% of 93 injuries belonged in the type B1 category. 29% of these showed no radiological signs of a PLC injury. Among the remaining cases, the following signs were the most frequently seen: vertebral segmental angle >15 degrees (44%), pronounced compression of vertebral cancellous bone despite minimal (<50%) reduced anterior vertebral height (41%), and a considerably reduced anterior vertebral height to <50% (31%). CONCLUSION: Type B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.
Authors: James S Harrop; Alexander R Vaccaro; R John Hurlbert; Jared T Wilsey; Eli M Baron; Christopher I Shaffrey; Charles G Fisher; Marcel F Dvorak; F C Oner; Kirkham B Wood; Neel Anand; D Greg Anderson; Moe R Lim; Joon Y Lee; Christopher M Bono; Paul M Arnold; Y Raja Rampersaud; Michael G Fehlings Journal: J Neurosurg Spine Date: 2006-02
Authors: C Knop; M Blauth; V Bühren; P M Hax; L Kinzl; W Mutschler; A Pommer; C Ulrich; S Wagner; A Weckbach; A Wentzensen; O Wörsdörfer Journal: Unfallchirurg Date: 1999-12 Impact factor: 1.000
Authors: A P Verheyden; A Hölzl; H Ekkerlein; E Gercek; S Hauck; C Josten; F Kandziora; S Katscher; C Knop; W Lehmann; R Meffert; C W Müller; A Partenheimer; C Schinkel; P Schleicher; K J Schnake; M Scholz; C Ulrich Journal: Unfallchirurg Date: 2011-01 Impact factor: 1.000
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Authors: Akhil P Verheyden; Ulrich J Spiegl; Helmut Ekkerlein; Erol Gercek; Stefan Hauck; Christoph Josten; Frank Kandziora; Sebastian Katscher; Philipp Kobbe; Christian Knop; Wolfgang Lehmann; Rainer H Meffert; Christian W Müller; Axel Partenheimer; Christian Schinkel; Philipp Schleicher; Matti Scholz; Christoph Ulrich; Alexander Hoelzl Journal: Global Spine J Date: 2018-09-07