[Clinical relevance of multislice CT of the spine after osteosynthesis].
OBJECTIVE
To examine the clinical relevance of multislice CT (MSCT) scans in postoperative checks of the spine after osteosynthesis.


METHODS
The results of x-rays (apical lateral) in 30 patients having spinal surgery involving osteosynthesis (5 x metastasis, 20 x fractures, 3 x spondylolisthesis, 2 x scoliosis) were correlated to those of MSCT (140 kV, 200 mAs, collimation 4 x 1 mm, pitch 0.75; VolumeZoom, Siemens, Erlangen, Germany) with multiplanar reconstruction. Two radiologists independently checked the conventional x-ray and multislice CT scans for anatomical positioning, damage of osteosynthetic material, and intraspinal dislocation of bone fragments.


RESULTS
By correlating conventional spinal x-rays with MSCT, additional diagnostic information was gained. In 9 of 30 patients MSCT revealed the extraosseal location of a screw tip (x-ray, 5/30), in 8/30 patients a narrowing of the spinal canal by osteosynthetic material was detected in MSCT (x-ray, 4/30), in 2/30 patients osteal fragments were detected in the vertebral canal by MSCT (x-ray, 0/30). In MSCT and in conventional x-ray a fracture of the osteosynthesis was correctly diagnosed in 3 patients. One patient underwent corrective surgery for dislocated osteosynthetic material, which was solely diagnosed with MSCT.


CONCLUSIONS
Due to the high degree of additional diagnostic information MSCT seems to be the method of choice for postoperative spinal surgery involving osteosynthesis.
Lorenzen
M
M
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie Radiologisches Zentrum, Universitätsklinikum Hamburg-Eppendorf. mlorenze@uke.uni-hamburg.de
Wedegärtner
U
U
Weber
C
C
Petersen
J P
JP
Adam
G
G
Lorenzen
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012600:Scoliosis / Q000601:surgery; D013122:Spinal Diseases / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery*; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging* / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*