title: Optimal thoracic and lumbar spine imaging for trauma: are thoracic and lumbar spine reformats always indicated?
abstract: BACKGROUND
  Computed tomography (CT) of the thoracic and lumbar (T/L) spine with reformats has become the imaging modality of choice for the identification of T/L spine fractures. The objective of this study was to directly compare chest/abdomen/pelvis CT (CAP CT) with CT with T/L reformats (T/L CT) for the identification of T/L spine fractures.
  
  
  METHODS
  Patients who had both a CAP CT scan (5-mm imaging spacing) and T/L CT reconstruction (2.5-mm image spacing with sagittal and coronal reformats) were selected. A "fracture" group (N = 35) and a "no fracture" group (N = 57) were identified. The type and level of fracture were recorded.
  
  
  RESULTS
  The CAP CT correctly identified all 35 patients with a thoracolumbar fracture (100% sensitivity; 95% confidence interval: 88-100%). A total of 80 separate fracture sites were present in the 35 patients. The CAP CT accurately identified 78 of those fractures (97.5% sensitivity; 95% confidence interval: 90.4-99.6%). The two fractures not identified on the CAP CT were both the transverse process fractures in patients with multiple fractures at different levels.
  
  
  CONCLUSIONS
  Patients who have a CAP CT do not require reformats for clearance of the T/L spine.
authors.affiliation: Department of Surgery and Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
authors.forename: D Joshua
authors.initials: DJ
authors.lastname: Mancini
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Burchard
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Pekala
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; 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 / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging