By PD Dr. Berthold Wimmer, Dr. Erich Hofmann, Dr. Augustinus L. H. Jacob (auth.)
Primary reconstructive surgical procedure is assuming expanding significance within the administration of fractures of the backbone. research of the harm and hence surgical decision-making are vastly facilitated by way of the diagnostic energy of CT and MRI. This quantity presents a systemic creation to the translation of CT and MRI photos of accidents to the spinal column and the spinal twine, with specific emphasis at the evaluate or residual balance. considering that survey X-rays stay the necessary first step in radiodiagnosis, the common appearances of spinal accidents on traditional movies also are proven. this can support the reader interpret the CT and MRI photos and in addition displays the process in radiologic perform. The book`s class of spinal fractures, including the try to finish how the damage occurred by way of reading the wear brought on, paves the best way for separately orientated therapy.
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Additional info for Trauma of the Spine: CT and MRI
Distractive flexion, 3. lateral flexion, 4. translational, 5. torsional flexion, 6. vertical compression, 7. distractive extension. Each of these is further subdivided into several stages of severity. These authors adopt the division of the spine into three anatomic regions, but reject the term "columns" as inappropriate. For the lower cervical spine, ALLEN et al.  put forward a corresponding but slightly differ- 28 Basic Considerations ent system whose axioms are also varied. Their most important basic assumption is that the direction of the forces exerted ("injury vectors") may be derived from the plain film of the cervical spine.
Two-dimensional reconstructions are now a part of the routine program. The computed images are about equivalent to conventional tomograms, but are free from any superimpositions. The resolution does not attain the quality of the original transverse sections. a) The Diagnostic Gap The greatest risk of misdiagnosis in computed tomography of a spinal injury is the overlooked fracture. A fracture will be overlooked if it is not detected on the plain film and the affected segment is not displayed by CT (see Fig.
The fracture is best de- tected in an open-mouth view, whereas the lateral view often appears normal. The lateral mass of the atlas is displaced laterally on both sides so that the space between the atlas and the dens is 40 Bone Injuries widened. If the sum of the bilateral offsets of the lateral masses exceeds 6- 7 mm it is probable that the transverse ligament is torn, in which case unstable conditions exist . b) Fracture of the Posterior Arch. In bilateral fractures the posterior fragment may be tilted cranially, as will be evident in the lateral view.