Learning objectives
The goals of this educational exhibit include a reliable approach for radiologists to the recognition,
evaluation,
and reporting of subtle traumatic injuries of the spine including any associated sequelae.
Background
Traumatic injuries to the spine are a common presentation of acute trauma across emergency departments in the United States and Canada.
Such traumatic injuries can be easily missed by the radiologist at first glance,
especially when appearing in a slew of similar appearing studies.
Spine fractures may be difficult to diagnose radiographically,
especially in the setting of multifocal trauma.
A missed diagnosis will contribute to a ten-fold increase in the chance for permanent neurologic deficit when compared to initial diagnosis.
Proper survey,
evaluation,
and reporting...
Findings and procedure details
Anatomy:
The cervical spine primarily functions to position the head while maintaining stability of the spinal cord.The thoracolumbar spine is the primary load-bearing structure of the axial skeleton.
Both sections of the spine are subject to multiple tangential forces,
which act around a fulcrum described as the instantaneous axis of rotation (IAR),
located in the posterior third of the vertebral body.Depending on the direction of the force vector acting on the IAR,
characteristic injury patterns such as the ones described below will result.
The patterns...
Conclusion
Imaging plays a key role in identifying traumatic injuries to the spine and any associated sequelae.
Knowledge of the many different sequelae of such injuries is essential in guiding appropriate management and prevention of long-term morbidity.
Personal information
Dr.
Perry Gerard,
MD,
MBA,
FACR
New York Medical College
Westchester Medical Center
Valhalla,
NY 10595
+1-914-493-8267
[email protected]
References
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Dreizin D,
Letzing M,
Sliker CW,
Chokshi FH,
Bodanapally U,
Mirvis SE,
Quencer RM,
and Munera F.
Multidetector CT of Blunt Cervical Spine Trauma in Adults.
Radiographics 2014; 34:1842-65.
2.Reid DC,
Henderson R,
Saboe L,
Miller JD.
Etiology and clinical course of missedspine fractures.
J Trauma 1987;27(9):980–6.
3.
Raniga SB,
Skalski MR,
Kirwadi A,
Menon VK,
Al-Azri FH,
and Butt S.
Thoracolumbar Spine Injury at CT.
Radiographics 2016; 36:2234-2235.
4.
Munera F,
Rivas LA,
Nunez DB,
and Quencer RM.
Imaging Evaluation of Adult Spinal...