CT scans versus conventional tomography in acute fractures of the odontoidprocess

Four different radiological diagnostic methods were compared as to their di agnostic relevance in the analysis of odontoid fractures. Thirty-one patien ts with fresh odontoid fractures were investigated using standard anteropos terior and lateral radiographs, conventional tomography, axial computerized tomography and two-dimensional reconstruction in the sagittal and the coro nal planes. As a control, 13 patients without odontoid fractures were exami ned. The results of the different investigations were correlated with the a ctual (clinical and/or intra-operative) findings. The coefficients of corre lation for the conventional tomography and two-dimensional reconstruction w ere kappa =0.774 and kappa =0.907, respectively. For conventional radiograp hy and axial computerized tomography (CT), the coefficients were clearly lo wer, at kappa =0.364 and kappa =0.627, respectively. The less time-consumin g CT examination with sagittal and coronal reconstructions is equivalent wi th respect to diagnostic accuracy and can, therefore, replace conventional tomography in the evaluation of odontoid fractures.