title: Radiography cannot examine disc injuries secondary to burst fracture: quantitative discomanometry validation.
abstract: METHODS
  An in vitro biomechanical study.
  
  
  OBJECTIVE
  To examine disc integrity at levels adjacent and next adjacent to the fractured vertebra and to determine if the disc injury can be revealed by radiographs.
  
  
  BACKGROUND
  Thoracolumbar burst fracture is one of the most common spinal injuries. A fractured vertebra is easy to recognize, but the associated disc injuries are less well known. The disc injury may not be apparent in radiographic images. Quantitative discomanometry, which measures disc pressure and the injected volume, has been found to detect disc injury.
  
  
  METHODS
  Nine specimens (T11-L3) with L1 burst fracture included adjacent discs (T12-L1 and L1-L2) and next-adjacent discs (T11-T12 and L2-L3) and were examined with radiographs and quantitative discomanometry, before and after the burst fracture. Statistical analyses were used to determine if the nine quantitative discomanometry parameters, in each of the four discs, were changed by the burst fracture and if the two next adjacent discs sustained different injuries.
  
  
  RESULTS
  After the burst fracture both the adjacent discs were shown to be injured by both radiographic and quantitative discomanometry examinations. Whereas both next-adjacent discs were found to be uninjured by radiograph examination, the quantitative discomanometry found the lower next-adjacent disc (L2-L3) to be injured.
  
  
  CONCLUSIONS
  Quantitative discomanometry was successful in finding disc injury, where the radiographs found none. The lower level, next adjacent disc is susceptible to injury during the burst trauma.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Jaw-Lin
authors.initials: JL
authors.lastname: Wang
authors.forename: Manohar M
authors.initials: MM
authors.lastname: Panjabi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kato
authors.forename: Carolyn
authors.initials: C
authors.lastname: Nguyen
authors.forename: Caroline
authors.initials: C
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D006801:Humans; D066298:In Vitro Techniques; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*; D008365:Manometry / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D011312:Pressure; D011859:Radiography; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000473:pathology*