[Type B injuries of the thoracolumbar spine : misinterpretations of the integrity of the posterior ligament complex using radiologic diagnostics].
BACKGROUND
Type B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries.


METHODS
Retrospective study evaluating 361 fractures.


RESULTS
Initially, 39 (41.9%) of 93 type B injuries were misdiagnosed as type A. 59% of 93 injuries belonged in the type B1 category. 29% of these showed no radiological signs of a PLC injury. Among the remaining cases, the following signs were the most frequently seen: vertebral segmental angle >15 degrees (44%), pronounced compression of vertebral cancellous bone despite minimal (<50%) reduced anterior vertebral height (41%), and a considerably reduced anterior vertebral height to <50% (31%).


CONCLUSIONS
Type B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.
Schnake
K J
KJ
Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland. klaus.schnake@bgu-frankfurt.de
von Scotti
F
F
Haas
N P
NP
Kandziora
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D003951:Diagnostic Errors; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging; D005858:Germany; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging / Q000293:injuries*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D055815:Young Adult