축상 및 시상면 재건 전산화 단층촬영 영상을 이용한 흉요추부 방출성 골절의 척추강내 골편 감입 측정 (Measurement of Canal Encroachment Using Axial and Sagittal-Reconstructed Computed Tomographic Images in Thoracolumbar Burst Fractures)

서지정보

· 발행기관 : 대한척추외과학회
· 수록지 정보 : 대한척추외과학회지 / 18권 / 3호 / 111 ~ 116페이지
· 저자명 : 김진호, 전창훈, 정남수, 임오경, 노형래

초록

Study Design: A retrospective study.
Objectives: The aim of this study was to examine the usefulness of axial and sagittal-reconstructed CT images in the evaluation of spinal canal encroachment by thoracolumbar burst fractures.
Summary of Literature Review: The dimensions of spinal canal encroachment by burst fractures have been described using axial CT images in the thoracolumbar region and sagittal-reconstructed images in the lower cervical region. However, the validity and reliability,depending on the measuring method, have not been fully evaluated.
Materials and Methods: A hundred and ninety-nine patients, who had diagnosed as a thoracolumbar burst fracture, were included in this study. Three orthopedic surgeons independently measured the canal encroachment of the burst fragment in the axial CT images and the sagittal-reconstructed images using the ratio of spinal length (method 1) and the ratio of area (method 2). The validity for the evaluation of the deformity and fracture stability was evaluated. In addition, the reliability of each method was assessed.
Results: Sixty-seven stable burst fractures and 132 unstable burst fractures were assessed. The mean kyphotic angle of stable and unstable burst fracture were 11.89 ± 8.49°and 15.90 ± 9.63°(P=0.005). The mean canal encroachment ratios of stable fracture were 17.21 ± 15.82 % (axial-method 1), 16.71 ±16.49 % (axial-method 2), 19.54 ± 17.03 % (sagittal reconstructed-method 1), and 11.75 ± 12.33% (sagittal reconstructed-method 2). The mean canal encroachment ratios of unstable fracture were 31.54 ± 17.10 % (axial-method 1), 29.67 ± 18.47 % (axial-method 2), 28.53 ± 18.60 % (sagittal reconstructed-method 1), and 21.20 ± 15.11 % (sagittal reconstructedmethod 2). There was no relationship between the fracture deformity and the canal encroachment ratio in all 4 methods. All ratios in the 4 method showed significant differences in the evaluation of fracture stability. All methods except method 1 in the sagittal-reconstructed images showed significant differences in the assessment of neurologic compromise.
Conclusions: The measurement of a canal encroachment area using axial and sagittal-reconstructed images was valid in the description of fracture stability.
Key Words: Thoracolumbar, Burst fracture, Canal encroachment, Computed tomography

영어초록

Study Design: A retrospective study.
Objectives: The aim of this study was to examine the usefulness of axial and sagittal-reconstructed CT images in the evaluation of spinal canal encroachment by thoracolumbar burst fractures.
Summary of Literature Review: The dimensions of spinal canal encroachment by burst fractures have been described using axial CT images in the thoracolumbar region and sagittal-reconstructed images in the lower cervical region. However, the validity and reliability,depending on the measuring method, have not been fully evaluated.
Materials and Methods: A hundred and ninety-nine patients, who had diagnosed as a thoracolumbar burst fracture, were included in this study. Three orthopedic surgeons independently measured the canal encroachment of the burst fragment in the axial CT images and the sagittal-reconstructed images using the ratio of spinal length (method 1) and the ratio of area (method 2). The validity for the evaluation of the deformity and fracture stability was evaluated. In addition, the reliability of each method was assessed.
Results: Sixty-seven stable burst fractures and 132 unstable burst fractures were assessed. The mean kyphotic angle of stable and unstable burst fracture were 11.89 ± 8.49°and 15.90 ± 9.63°(P=0.005). The mean canal encroachment ratios of stable fracture were 17.21 ± 15.82 % (axial-method 1), 16.71 ±16.49 % (axial-method 2), 19.54 ± 17.03 % (sagittal reconstructed-method 1), and 11.75 ± 12.33% (sagittal reconstructed-method 2). The mean canal encroachment ratios of unstable fracture were 31.54 ± 17.10 % (axial-method 1), 29.67 ± 18.47 % (axial-method 2), 28.53 ± 18.60 % (sagittal reconstructed-method 1), and 21.20 ± 15.11 % (sagittal reconstructedmethod 2). There was no relationship between the fracture deformity and the canal encroachment ratio in all 4 methods. All ratios in the 4 method showed significant differences in the evaluation of fracture stability. All methods except method 1 in the sagittal-reconstructed images showed significant differences in the assessment of neurologic compromise.
Conclusions: The measurement of a canal encroachment area using axial and sagittal-reconstructed images was valid in the description of fracture stability.
Key Words: Thoracolumbar, Burst fracture, Canal encroachment, Computed tomography

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