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01-05-2017 | Original Article

The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture

Authors: Jiao-Xiang Chen, Amit Goswami, Dao-Liang Xu, Jun Xuan, Hai-Ming Jin, Hong-Ming Xu, Feng Zhou, Yong-Li Wang, Xiang-Yang Wang

Published in: European Spine Journal | Issue 5/2017

Abstract

Purposes

To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).

Methods

One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (A/P ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV). T test, Pearson’s Chi-square and multivariate logistic regression were calculated for the variables.

Results

Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm, P = 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°, P = 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°, P = 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (P = 0.004 and P < 0.001, respectively), increased AED (P = 0.010), LK >25° (P = 0.024), AVH (P < 0.001), and BFOFV (P < 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408, P = 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494, P = 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (P = 0.035 and 0.001, respectively) or SSL rupture (P = 0.014 and 0.008, respectively).

Conclusion

Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI, A/P ratio, and AVH ratio are not.

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Title: The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture
Authors: Jiao-Xiang Chen
Amit Goswami
Dao-Liang Xu
Jun Xuan
Hai-Ming Jin
Hong-Ming Xu
Feng Zhou
Yong-Li Wang
Xiang-Yang Wang
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4687-x

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Springer Medicine

The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture

Abstract

Purposes

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purposes

Methods

Results

Conclusion

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