The radiologic assessment of post-traumatic vertebral stability.
The stability of the vertebral column depends upon the integrity of the bones, ligaments, and joints. The vertebral column can be divided into three distinct anatomic zones: anterior, middle, and posterior. Disruption of any single zone does not produce instability. Disruption of two contiguous zones will, however, significantly decrease the load-carrying capability of the spine and result in instability. Five radiographic signs indicative of vertebral instability have been identified: (1) displacement implies injury to major ligamentous and articular structures; (2) a wide interlaminar space implies injury to the posterior ligamentous structures and the facet joints; (3) wide facet joints imply injury to the posterior ligamentous structures; (4) a disrupted posterior vertebral body line implies burst injury with disruption of anterior bony and posterior ligamentous structures; (5) a wide vertebral canal implies injury to the entire vertebra in the sagittal plane. Each of these signs indicates disruption of a major skeletal, ligamentous, or articular structure and the presence of only one is sufficient to establish a diagnosis of instability. These conclusions are based upon a study of 138 injuries observed in 125 patients.
Daffner
R H
RH
Department of Diagnostic Radiology, Allegheny General Hospital, Medical College of Pennsylvania, Pittsburgh 15212-9986.
Deeb
Z L
ZL
Goldberg
A L
AL
Kandabarow
A
A
Rothfus
W E
WE
D050723:Fractures, Bone / Q000000981:diagnostic imaging; D050724:Fractures, Cartilage; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000293:injuries; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D011859:Radiography; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000293:injuries; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D013131:Spine / Q000000981:diagnostic imaging*