RESEARCH PAPER
Use of multi-planar reconstruction (MPR) and 3-dimentional (3D) CT to assess stability criteria in C2 vertebral fractures
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1
II Department of Radiology, Medical University of Lublin, Poland
2
Department of Traumatology, Medical University of Lublin, Poland
3
Department of Diagnostic Imaging, St. Lukas Hospital in Tarnów, Poland
Corresponding author
Witold Krupski
II Department of Radiology, Medical University, Jaczewskiego 8, 20-081 Lublin, Poland.
J Pre Clin Clin Res. 2007;1(1):80-83
KEYWORDS
ABSTRACT
The aim of the research was to assess the possibility of use of Roy-Camille’s criteria to estimate the stability of axis fractures on CT images using multi-planar (MPR) and 3-dimensional (3D) reconstructions. 10 patients, aged 17-73
(mean 48.7), with C2 fractures and cervical spine radiograms performed previously, underwent CT examinations supplemented with secondary MPR and 3D reconstructions. A dental fracture of type III, according to Anderson,
was diagnosed in 4 patients, a Hangman’s fracture in 1 patient and a Roy-Camille’s fractures in 5 patients, with a co-existing C1 fracture in 1 patient. To estimate translations of vertebral bodies or bone fragments of the fractured dens, we used sagittal MPR and 3D reconstructions in the median plane and calculated the anterior translation (AT), posterior translation (PT) and regional angulation (RA). In 3 cases of dental fractures, PT of the dental fragment and of the axis vertebral body measured 5.5-7 mm. In 1 case of these fractures, AT was 3.5 mm. In 1 case of Hangman’s fracture we did not observe any translations. In 5 cases of Roy-Camille’s fractures, AT was < 3.5 mm in 1 patient and > 3.5 mm in 4 patients. The biggest AT measured 6 mm. On axial CT images translations could be visualised only in 3 cases. In 2 patients, RA was -1 and 6°. It was concluded that the use of multi-planar and 3D reconstructions on CT
images enables assessment of AT, PA and RA in order to determine the stability criteria in C2 vertebral fractures.
REFERENCES (12)
1.
Blackmore CC, Emerson SS, Mann FA, Koepsell TD: Cervical Spine Imaging in Patients with Trauma: Determination of Fracture Risk to Optimize Use. Radiology 1999, 211, 759-765.
2.
Blackmore CC, Ramsey SD, Mann FA, Deyo RA: Cervical Spine Screening with CT in Trauma Patients: A Cost-effectiveness Analysis. Radiology 1999, 212, 117-125.
3.
Lee HJ, Sharma V, Shah K, Gor D: The role of spiral CT vs plain films in acute cervical spine trauma: a comparative study. Emergen Radiol 2001, 8, 311 314.
4.
Ptak T, Kihiczak D, Lawrason JN, Rhea JT, Sacknoff R, Godfrey RR, Novelline RA: Screening for cervical spine trauma with helical CT: experience with 676 cases. Emergen Radiol 2001, 8, 315-319.
5.
Vieweg U, Meyer B, Schramm J: Differential Treatment in Acute Upper Cervical Spine Injuries: a critical review of a single-institution series. Surg Neurol 2000, 54, 203-211.
6.
Arslantas A, Atasoy MA, Güner AI, Cosan E, Durmaz R, Adapinar B, Tel E: Three-dimensional computed tomography in spinal pathologies. Radiography 2002, 8, 173-179.
7.
Rizzolo SJ, Vaccaro AR, Cotler JM: Cervical spine trauma. Spine 1994, 19(20), 2288-2298.
8.
Calhoun PS, Kuszyk BS, Heath DG, Carley JC, Fischman EK: Threedimensional Volume Rendering of Spiral CT Date: Theory and Method. Radiographics 1999, 19, 745-764.
9.
Fairholm D, Lee ST, Lui TN: Fractured odontoid: The management of delayed neurosurgical symptoms. Neurosurg 1996, 38, 38-43.
10.
Woodring JH., Lee C.: Limitations of cervical radiography in the evaluation of acute cervical trauma. J Trauma 1993, 34, 32-39.
11.
Woodring JH, Lee C: The role and limitations of computed tomographic scanning in the evaluation of the cervical trauma. J Trauma 1992, 33(5), 698-708.
12.
Delfini R, Dorizzi A, Facchinetti G, Faccioli F, Galzio R, Vangelista T: Delayed Post-Traumatic Cervical Instability. Surg Neurol 1999, 51, 588-595.