Computed Tomography of Thoracic and Lumbar Spine Injuries

Abstract

CT [computed tomography] scans of 73 patients with acute thoracic/lumbar spine injuries from T3 to L5 were reviewed. Injuries were classified as burst fractures (48), fracture-dislocations (10), wedge compression fractures (11) and seatbelt-type injuries (4). Thirty-one (42%) had motor deficits due to spinal cord or nerve root damage. Such neurologic deficts were present in all patients with fracture-dislocations, and 60% of those with burst fractures. Seven patients, 4 initially normal, developed progressive neurologic impairment early after injury. Burst fractures, 1 with dislocation, were the spinal injury associated with each progressive deficit. Burst fractures at T12 or L1 with 50% or more decrease of the mid-sagittal neural canal diameter had a significant risk of neurologic involvement, and of progressive deficit. CT scans demonstrate vertebral column damage well, and help identify those patients at risk of acute neurologic compromise.