THORACOLUMBAR BURST FRACTURES - EVALUATION WITH MR-IMAGING

PURPOSE: To determine the frequency of posterior ligamentous injury th at occurs in patients with theracolumbar burst fractures and to correl ate ligamentous disruption with radiographic appearance. MATERIALS AND METHODS: Magnetic resonance (MR) imaging examinations of 21 patients with 25 thoracolumbar burst fractures were retrospectively evaluated t o determine spinal ligament integrity. Radiographic and computed tomog raphic (CT) examinations were evaluated for interpediculate widening, midsagittal canal narrowing, posterior element fractures, and kyphosis ; a radiographic assessment of posterior ligamentous integrity was mad e. These findings were then correlated with the status of the spinal l igaments. RESULTS: The patients were divided into two groups on the ba sis of the status of their supraspinous ligament (SSL). Six patients h ad disrupted SSLs, and 15 had intact SSLs. Radiographic and CT finding s did not correlate with supraspinous ligament. disruption. Radiograph ic indicators of posterior ligamentous disruption were-present in only 33% of patients with SSL disruption. CONCLUSION: SSL disruption is a frequent occurrence in patients with burst fractures. No radiographic features of burst fractures correlate with SSI, disruption, and radiog raphic signs of posterior ligamentous disruption are insensitive.