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European Spine Journal

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12-02-2024 | Magnetic Resonance Imaging | Review Article

How frequently MRI modifies thoracolumbar fractures’ classification or decision-making? A systematic review and meta-analysis

Authors: Mohamed M. Aly, Youssef Soliman, Rmy A. Elemam, Javier Pizones, Ahmed Alzahrani, Sherif Elwatidy

Published in: European Spine Journal | Issue 4/2024

Abstract

Purpose

To provide the first meta-analysis of the impact of magnetic resonance imaging (MRI) on thoracolumbar fractures (TLFs) classification and decision-making.

Methods

A systematic review was conducted following PRISMA guidelines. We searched PubMed, Scopus, Cochrane, and Web of Science from inception to June 30, 2023 for studies evaluating the change in TLFs classification and treatment decisions after MRI. The studies extracted key findings, objectives, and patient population. A meta-analysis was performed for the pooled frequency of change in AO fracture classification or treatment decisions from surgical to conservative or vice versa after MRI.

Results

This meta-analysis included four studies comprising 554 patients. The pooled frequency of change in TLFs classification was 17% (95% CI 9–31%), and treatment decision was 22% (95% CI 11–40%). An upgrade from type A to type B was reported in 15.7% (95% CI 7.2–30.6%), and downgrading type B to type A in 1.2% (95% CI 0.17–8.3%). A change from conservative to surgery recommendation of 17% (95% CI 5.0–43%) was higher than a change from surgery to conservative 2% (95% CI 1–34%).

Conclusions

MRI can significantly change the thoracolumbar classification and decision-making, primarily due to upgrading type A to type B fractures and changing from conservative to surgery, respectively. These findings suggest that MRI could change decision-making sufficiently to justify its use for TLFs. Type A subtypes, indeterminate PLC status, and spine regions might help to predict a change in TLFs’ classification. However, more studies are needed to confirm the association of these variables with changes in treatment decisions to set the indications of MRI in neurologically intact patients with TLFs. An interactive version of our analysis can be accessed from here: https://databoard.shinyapps.io/mri_spine/.

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Title: How frequently MRI modifies thoracolumbar fractures’ classification or decision-making? A systematic review and meta-analysis
Authors: Mohamed M. Aly
Youssef Soliman
Rmy A. Elemam
Javier Pizones
Ahmed Alzahrani
Sherif Elwatidy
Publication date: 12-02-2024
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Pityriasis Lichenoides Chronica
Computed Tomography
Computed Tomography
Published in: European Spine Journal / Issue 4/2024
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-08087-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How frequently MRI modifies thoracolumbar fractures’ classification or decision-making? A systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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