BROOKLYN 3 STUDENTS Sophie PERYMAN Fri 30 th Aug 2013 Session 2 / Talk 3 10:55 – 11:05 ABSTRACT Traumatic spinal fractures are not particularly commonplace in emergency departments. However, due to the risks of debilitation it is essential for patients to be accurately imaged and diagnosed in order for the most appropriate treatment plan to put in place. This paper will specifically discuss burst fractures: mechanism of injury, clinical signs, imaging options (historical and current thinking) and prognosis. Burst fractures account for 17% of all spinal fractures and due to their nature, are often associated with compromise of the spinal canal to some degree. With the rapid technological advances in imaging modalities, the options for imaging burst fractures have evolved. In order to ensure best practice, consideration should be given to choosing the most appropriate technologies instead of being tempted to use all of the modalities. This paper will explore the current multimodality approaches to imaging burst fractures in order to demonstrate the essential role of the MIT in optimizing the patient pathway.
BURST FRACTURES A Multimodality imaging approach Sophie Peryman Bachelor of Health Science (Medical Imaging) Unitec A Multimodality imaging approach Sophie Peryman Bachelor of Health Science (Medical Imaging) Unitec
OVERVIEW Definition Mechanisms of injury Classification systems Imaging pathways Summary
ASIANIA AIRLINES CRASH
ASIANIA AIRLINES CRASH
ASIANIA AIRLINES CRASH
BURST FRACTURE DEFINED Failure of anterior and middle margins Potential for neurological damage Typical mechanisms of injury
MECHANISMS OF INJURY
INTERVERTEBRAL DISKS
3-COLUMN CLASSIFICATION SYSTEM Denis (1983) Anterior column Middle column Posterior column Middle column considered to be of paramount importance to spinal stability
THORACOLUMBAR INJURY CLASSIFICATION & SEVERITY SCORE (TLICS) Vaccaro (2005) Based on three important injury characteristics: 1.Morphology of injury 2.Integrity of posterior ligamentous complex 3.Neurological status of the patient
CHOICE OF IMAGING MODALITY Cassar-Pullicino & Tins (2006) claim the biggest problem of imaging spinal injury patients is the choice of the appropriate imaging modality in the different stages of patient care.
CHOICE OF IMAGING MODALITY: XRAY 1.Severe compression of vertebral body 1.Disruption of posterior body line 1.Widening of interpedicle distance Abitol et al. (1992)
CHOICE OF IMAGING MODALITY: XRAY
CHOICE OF IMAGING MODALITY: CT
CHOICE OF IMAGING MODALITY: CT
CHOICE OF IMAGING MODALITY: MRI
SUMMARY
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