3-DIMENSIONAL COMPUTED TOMOGRAPHIC IMAGING IN THE DIAGNOSIS OF VERTEBRAL COLUMN TRAUMA - EXPERIENCE-BASED ON 21 PATIENTS AND REVIEW OF THE LITERATURE

Objective: To compare standard x-ray films, two-dimensional computed t omographic reconstructions and three-dimensional (3-D) computed tomogr aphic reconstructions for assessing the grade, extent, and severity of vertebral fracture. Patients and methods: 3-D images were created fro m standard computed tomographic scans obtained using a General Electri c PACE scanner. In 21 patients (17 men and four women) these images we re obtained during both the acute phase and at longterm follow-up; the re were sis cervical, four dorsal, five dorsolumbar, and six Lumbar fr actures. Results: The 3-D images supplied useful information in comple x traumas with rotation and/or dislocation of the vertebral body and i n cases with loss of spinal alignment, The 3-D images also proved to b e useful as an adjunctive imaging method for evaluation of bone fusion integrity. Conclusion: 3-D images produced by recently available soft ware provide a 3-D understanding much more readily than do multiple tw o-dimensional images, Because it would be very difficult to standardiz e this method of imaging, it seems best that the specialist (orthopedi c surgeon, neurosurgeon, neuroradiologist) be present during the inves tigation to decide the viewing angles, An important limitation to this method is the presence of degenerative disease or osteoporosis, mainl y in elderly patients.