Is magnetic resonance imaging needed for decision making diagnosis and treatment of thoracic and lumbar vertebral fractures?
European Journal of Orthopaedic Surgery and Traumatology, ISSN: 1432-1068, Vol: 33, Issue: 1, Page: 107-115
2023
- 8Citations
- 6Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations8
- Citation Indexes8
- CrossRef1
- Captures6
- Readers6
Article Description
Purpose: The radiological examination including plain radiography, CT and MRI are critical to assess the severity of the instability, to diagnose the fracture type and to select the appropriate treatment strategy for the thoracic and lumbar vertebral fractures. The aim of this prospective observational study was to investigate the effect of magnetic resonance imaging (MRI) on decision making for the diagnosis and treatment of acute thoracic and lumbar vertebral fractures. Methods: Consecutive 180 patients with acute thoracic and/or lumbar vertebral fractures were included in the study. The fracture pattern was evaluated by using initial radiographs, computed tomography (CT) and MRI within 24 h of trauma. Fractures were classified according to AO classification before and after MRI. TLICS classification was also used to decide treatment plan. MRI findings were compared to surgical findings in the surgically treated patients. Results: A significant moderate agreement was found between Xray + CT and post-MRI classifications for all fracture types (Kappa = 0.511; p < 0.001). In 101 patients with new findings on MRI, a significant moderate correlation was observed between Xray + CT and post-MRI classifications in the fracture re-classification (Kappa = 0.441, p < 0.001). There was a significant change in the treatment plan of patients with new findings on MRI according to Xray + CT (p < 0.0001). After MRI evaluation, the treatment plan changed in favor of surgery in 33.9% of patients who were scheduled for conservative treatment according to Xray + CT (p < 0.0001). Conclusion: Since MRI assessment of acute thoracic and/or lumbar injuries has led to a remarkable treatment change decision that confirms intraoperative findings of the patients who were decided to undergo surgery, MRI should be obtained in thoracic and lumbar vertebral fractures, regardless of the CT and plain radiographic findings. Level of evidence: Level II, prospective observational study.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85120649594&origin=inward; http://dx.doi.org/10.1007/s00590-021-03165-z; http://www.ncbi.nlm.nih.gov/pubmed/34817659; https://link.springer.com/10.1007/s00590-021-03165-z; https://dx.doi.org/10.1007/s00590-021-03165-z; https://link.springer.com/article/10.1007/s00590-021-03165-z
Springer Science and Business Media LLC
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