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How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?

STUDY DESIGN: retrospective study of consecutive patients OBJECTIVE: to analyze the frequency of change in Thoracolumbar fractures (TLFs) classification or decision-making after MRI compared by CT alone. METHODS: A retrospective review of 244 consecutive patients with acute TLFs (T1-L5) presented to...

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Autores principales: Aly, Mohamed M., Al-Shoaibi, Abdulbaset M., Abduraba Ali, Saleh, Al Fattani, Areej, Eldawoody, Hany
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676184/
https://www.ncbi.nlm.nih.gov/pubmed/35382642
http://dx.doi.org/10.1177/21925682221089579
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author Aly, Mohamed M.
Al-Shoaibi, Abdulbaset M.
Abduraba Ali, Saleh
Al Fattani, Areej
Eldawoody, Hany
author_facet Aly, Mohamed M.
Al-Shoaibi, Abdulbaset M.
Abduraba Ali, Saleh
Al Fattani, Areej
Eldawoody, Hany
author_sort Aly, Mohamed M.
collection PubMed
description STUDY DESIGN: retrospective study of consecutive patients OBJECTIVE: to analyze the frequency of change in Thoracolumbar fractures (TLFs) classification or decision-making after MRI compared by CT alone. METHODS: A retrospective review of 244 consecutive patients with acute TLFs (T1-L5) presented to a single level 1 trauma center between 2014 and 2021. Three and 4 reviewers independently classified all fractures according to AOSpine and AOSpine injury severity score (TLAOSIS) by CT then MRI, respectively. Posterior ligamentous complex Injury (PLC) was diagnosed on CT and MRI by ≥ 2 positive CT findings and Black stripe discontinuity. RESULTS: MRI changed AO classification in 25/244 patients (10.2%, P < .0001) due to an 8.2% upgrade from type A to type B and a 2% downgrade from type B to type A. The addition of MRI changed TL AOSIS among the 3 treatment recommendation groups in 35/244 (19.7%, 95% CI [14.9%-25.2%]. The best predictor of upgrade from type A to type B and downgrade from type B to type A was a single positive CT finding and the presence of only 2 CT signs as opposed to ≥3 signs, respectively (P < .0001 P = .03, respectively). Thoracic fractures showed a significantly higher reclassification rate than thoracolumbar and low lumbar (20% vs 10% and 0%, respectively, P = .07). CONCLUSION: using appropriate CT/MRI criteria for PLC injury, MRI changed the AOSpine classification by 10% and TLAOSIS based treatment by 19.7%. The best predictors of fracture reclassification by MRI were the number of positive CT findings and fracture level.
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spelling pubmed-106761842022-04-05 How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone? Aly, Mohamed M. Al-Shoaibi, Abdulbaset M. Abduraba Ali, Saleh Al Fattani, Areej Eldawoody, Hany Global Spine J Original Articles STUDY DESIGN: retrospective study of consecutive patients OBJECTIVE: to analyze the frequency of change in Thoracolumbar fractures (TLFs) classification or decision-making after MRI compared by CT alone. METHODS: A retrospective review of 244 consecutive patients with acute TLFs (T1-L5) presented to a single level 1 trauma center between 2014 and 2021. Three and 4 reviewers independently classified all fractures according to AOSpine and AOSpine injury severity score (TLAOSIS) by CT then MRI, respectively. Posterior ligamentous complex Injury (PLC) was diagnosed on CT and MRI by ≥ 2 positive CT findings and Black stripe discontinuity. RESULTS: MRI changed AO classification in 25/244 patients (10.2%, P < .0001) due to an 8.2% upgrade from type A to type B and a 2% downgrade from type B to type A. The addition of MRI changed TL AOSIS among the 3 treatment recommendation groups in 35/244 (19.7%, 95% CI [14.9%-25.2%]. The best predictor of upgrade from type A to type B and downgrade from type B to type A was a single positive CT finding and the presence of only 2 CT signs as opposed to ≥3 signs, respectively (P < .0001 P = .03, respectively). Thoracic fractures showed a significantly higher reclassification rate than thoracolumbar and low lumbar (20% vs 10% and 0%, respectively, P = .07). CONCLUSION: using appropriate CT/MRI criteria for PLC injury, MRI changed the AOSpine classification by 10% and TLAOSIS based treatment by 19.7%. The best predictors of fracture reclassification by MRI were the number of positive CT findings and fracture level. SAGE Publications 2022-04-05 2024-01 /pmc/articles/PMC10676184/ /pubmed/35382642 http://dx.doi.org/10.1177/21925682221089579 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Aly, Mohamed M.
Al-Shoaibi, Abdulbaset M.
Abduraba Ali, Saleh
Al Fattani, Areej
Eldawoody, Hany
How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title_full How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title_fullStr How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title_full_unstemmed How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title_short How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
title_sort how often would mri change the thoracolumbar fracture classification or decision-making compared to ct alone?
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676184/
https://www.ncbi.nlm.nih.gov/pubmed/35382642
http://dx.doi.org/10.1177/21925682221089579
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