LUMBOSACRAL JUNCTION INJURY ASSOCIATED WITH UNSTABLE PELVIC FRACTURE - CLASSIFICATION AND DIAGNOSIS

Citation
A. Leone et al., LUMBOSACRAL JUNCTION INJURY ASSOCIATED WITH UNSTABLE PELVIC FRACTURE - CLASSIFICATION AND DIAGNOSIS, Radiology, 205(1), 1997, pp. 253-259
Citations number
36
Categorie Soggetti
Radiology,Nuclear Medicine & Medical Imaging
Journal title
ISSN journal
00338419
Volume
205
Issue
1
Year of publication
1997
Pages
253 - 259
Database
ISI
SICI code
0033-8419(1997)205:1<253:LJIAWU>2.0.ZU;2-I
Abstract
PURPOSE: To determine the types and prevalence of lumbosacral junction injuries associated with an unstable pelvic fracture and to assess th e diagnostic value of conventional radiographic and computed tomograph ic (CT) findings. MATERIALS AND METHODS: Anteroposterior, inlet, and o utlet radiographs and CT scans in 97 patients with pelvic disruption w ere retrospectively reviewed. RESULTS: Unstable pelvic fractures were seen on radiographs in 73 patients, 42 of whom had a sacral fracture. Fourteen of these 42 patients had an associated L5-S1 facet joint inju ry (three extraarticular, nine articular, and two complex). In three o f these 14 patients, the L-5 body was laterally bent by more than 10 d egrees, with asymmetric L5-S1 intervertebral space. The diagnosis in n ine of the 14 patients with an associated lumbosacral junction injury was rendered on the basis of CT findings only. CONCLUSION: Lumbosacral junction injury must be considered in patients with an unstable pelvi c fracture, especially in those with an associated sacral fracture. CT is necessary because these conditions may be overlooked on radiograph s, although outlet radiographs are better than CT scans for depicting the possibly associated L5-S1 intervertebral disk lesion.