MUSCULOSKELETAL RADIOLOGY / ORIGINAL PAPER
Acute thoracolumbar fractures in patients with a rigid spine: a computed tomography study
1
1st Department of Clinical Radiology, Medical University of Warsaw, Poland
2
Department of Orthopaedics and Traumatology of the Locomotor System, Medical University of Warsaw, Poland
3
Department of Emergency Medicine, Medical University of Warsaw, Poland
Submission date: 2025-03-04
Acceptance date: 2025-04-08
Publication date: 2025-05-09
Corresponding author
Marlena Bereźniak
1st Department of Clinical Radiology, Medical University of Warsaw, 5 Chałubińskiego St., 02-004 Warsaw, Poland
1st Department of Clinical Radiology, Medical University of Warsaw, 5 Chałubińskiego St., 02-004 Warsaw, Poland
Pol J Radiol, 2025; 90: 215-223
KEYWORDS
TOPICS
ABSTRACT
Purpose:
To assess the influence of long- and short-segment spinal ankylosis on the characteristics and course of acute thoracolumbar fractures.
Material and methods:
Computed tomography (CT) studies of 372 patients who were diagnosed with acute thoracolumbar spine fracture in our hospital between 2014 and 2020 were retrospectively reviewed. Demographic data, presence or absence of rigid spine conditions, location, and fracture morphology according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) spine classification were assessed. Statistical analysis was performed using the x2 test.
Results:
A total of 65 patients with fractures through ankylosed segment or immediately adjacent segment (rigid spine group) and 307 controls were identified. Most rigid spine patients suffered minor trauma. In both groups most of the fractures were located in the thoracolumbar junction, and type A1 fractures were most common, followed by types A3 and A4. Multilevel fractures were more common in rigid spine patients (41.54% vs. 30.29%). Most of the rigid spine fractures (46.96%) were located within the fused spinal segment, with the midportion of the fused spinal segment being the most common location of types B and C fractures. Long-segment fusion was associated with unstable type B and C fractures. In short-segment fusion, single level type A fractures were most common. Spinal cord injury occurred only in patients with delayed diagnosis.
Conclusions:
When plain films are used as a first-line diagnostic test for thoracolumbar spine trauma in stable patients without abnormal neurological signs or symptoms, and long-segment spinal ankylosis is observed, thoracolumbar CT should be used for further evaluation.
To assess the influence of long- and short-segment spinal ankylosis on the characteristics and course of acute thoracolumbar fractures.
Material and methods:
Computed tomography (CT) studies of 372 patients who were diagnosed with acute thoracolumbar spine fracture in our hospital between 2014 and 2020 were retrospectively reviewed. Demographic data, presence or absence of rigid spine conditions, location, and fracture morphology according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) spine classification were assessed. Statistical analysis was performed using the x2 test.
Results:
A total of 65 patients with fractures through ankylosed segment or immediately adjacent segment (rigid spine group) and 307 controls were identified. Most rigid spine patients suffered minor trauma. In both groups most of the fractures were located in the thoracolumbar junction, and type A1 fractures were most common, followed by types A3 and A4. Multilevel fractures were more common in rigid spine patients (41.54% vs. 30.29%). Most of the rigid spine fractures (46.96%) were located within the fused spinal segment, with the midportion of the fused spinal segment being the most common location of types B and C fractures. Long-segment fusion was associated with unstable type B and C fractures. In short-segment fusion, single level type A fractures were most common. Spinal cord injury occurred only in patients with delayed diagnosis.
Conclusions:
When plain films are used as a first-line diagnostic test for thoracolumbar spine trauma in stable patients without abnormal neurological signs or symptoms, and long-segment spinal ankylosis is observed, thoracolumbar CT should be used for further evaluation.
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