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European Spine Journal

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01-04-2016 | Original Article

Multilevel non-contiguous spinal injuries: incidence and patterns based on whole spine MRI

Authors: Rishi Mugesh Kanna, Chandrasekar V. Gaike, Anupama Mahesh, Ajoy Prasad Shetty, S. Rajasekaran

Published in: European Spine Journal | Issue 4/2016

Abstract

Purpose

Multi-level non-contiguous spinal injuries are not uncommon and their incidence varies from 1.6 to 77 % depending on the type of imaging modality used. Delayed diagnosis and missed spinal injuries in non-contiguous spine fractures have been frequently described which can result in significant pain, deformity and neurological deficit. The efficacy of whole spine MRI in detecting asymptomatic significant vertebral fractures is not known.

Methodology

Consecutive spinal injury patients treated between 2011 and 2013 were retrospectively evaluated based on clinical and radiographic records. Patients’ demographics, mode of injury, presence of associated injuries, clinical symptoms and the presence of neurological deficit were studied. Radiographs of the fractured region and whole spine MRI were evaluated for the presence of multi-level injuries.

Results

Among 484 patients, 95 (19.62 %) patients had multilevel injuries including 86 (17.76 %) with non-contiguous injuries. Five common patterns of non-contiguous spinal injuries were observed. Pattern I: cervical and thoracic—29.1 %, Pattern II: thoracolumbar and lumbosacral—22.1 %, Pattern III: thoracic and thoracolumbar—12.8 %, Pattern IV: cervical and thoracolumbar—9.1 % and Pattern V: lumbosacral and associated injuries—9.0 %. The incidence of intra-regional non-contiguous injuries was 17.4 %. Whole spine MRI scan detected 24 (28.6 %) missed secondary injuries of which 5 were unstable.

Conclusion

The incidence of multilevel non-contiguous spine injury using whole spine MRI imaging is 17.76 %. Five different patterns of multi-level non-contiguous injuries were found with the most common pattern being the cervical and thoracic level injuries. The incidence of unstable injuries can be as high as 21 % of missed secondary injuries.

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Title: Multilevel non-contiguous spinal injuries: incidence and patterns based on whole spine MRI
Authors: Rishi Mugesh Kanna
Chandrasekar V. Gaike
Anupama Mahesh
Ajoy Prasad Shetty
S. Rajasekaran
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 4/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4209-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Multilevel non-contiguous spinal injuries: incidence and patterns based on whole spine MRI

Abstract

Purpose

Methodology

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methodology

Results

Conclusion

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