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A Modified MRI Protocol for the Increased Detection of Sacrococcygeal Fractures in Patients with Thoracolumbar Junction Fractures

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Journal Sci Rep
Specialty Science
Date 2021 Mar 12
PMID 33707558
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Abstract

This study aimed to identify concurrent thoracolumbar junction (TLJ) and sacrococcygeal (SC) fractures using a modified MRI protocol and analyze the risk factors associated with tandem fractures. We retrospectively investigated patients with MRI-confirmed TLJ fractures from January 2017 to March 2020. Patients were divided into two study groups: study 1 with a modified MRI protocol and study 2 with a routine protocol. The modified protocol included an extended field of view of sagittal scans in L-spine MRI covering the full SC spine. In study 1, frequency of concurrent TLJ and SC fractures was investigated. And we analyzed risk factors and compared CT and MRI for detecting SC fractures. In study 2, co-occurrence of both fractures was investigated. A total of 176 and 399 patients with TLJ fractures were enrolled in study 1 and 2, then SC fractures were identified in 53 (30.14%) and 36 patients (9.02%), respectively. An axial loading trauma mechanism was a significant risk factor (Odds ratio 7.0, p < 0.001), and MRI was more sensitive than CT in detecting SC fractures (p < 0.002). Thus, a modified MRI protocol was useful to detect the high occurrence of SC fractures in TLJ fractures, which concurrent fractures increased by an axial loading mechanism.

References
1.
Rodrigues-Pinto R, Kurd M, Schroeder G, Kepler C, Krieg J, Holstein J . Sacral Fractures and Associated Injuries. Global Spine J. 2017; 7(7):609-616. PMC: 5624377. DOI: 10.1177/2192568217701097. View

2.
Shah L, Hanrahan C . MRI of spinal bone marrow: part I, techniques and normal age-related appearances. AJR Am J Roentgenol. 2011; 197(6):1298-308. DOI: 10.2214/AJR.11.7005. View

3.
Mohamadi A, Googanian A, Ahmadi A, Kamali A . Comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with Score 4 of TLICS: A randomized, single-blind, and single-central clinical trial. Medicine (Baltimore). 2018; 97(6):e9842. PMC: 5944701. DOI: 10.1097/MD.0000000000009842. View

4.
Korres D, Boscainos P, Papagelopoulos P, Psycharis I, Goudelis G, Nikolopoulos K . Multiple level noncontiguous fractures of the spine. Clin Orthop Relat Res. 2003; (411):95-102. DOI: 10.1097/01.blo.0000068362.47147.a2. View

5.
Kaniewska M, de Beus J, Ahlhelm F, Mameghani A, Eid K, Kubik-Huch R . Whole spine localizers of magnetic resonance imaging detect unexpected vertebral fractures. Acta Radiol. 2018; 60(6):742-748. DOI: 10.1177/0284185118796673. View