title: Spinal hyperostosis as an important sign indicating spine injuries on postmortem computed tomography.
abstract: Although spine injuries are not always detectable on postmortem computed tomography (PMCT), spinal hyperostosis, an important risk factor for spine injury, is relatively easily detectable on PMCT. We therefore examined the utility of the detection of spinal hyperostosis on PMCT as an indicator of spine injury. Full-body PMCT images of 88 autopsy cases with a bruise on the face or forehead but no identifiable skull fracture were reviewed prior to autopsy for the identification and classification of spinal hyperostosis. Spine injuries were observed in 56.0% of cases with spinal hyperostosis and 1.6% of cases without spinal hyperostosis. Among the cases with spinal hyperostosis, spine injuries were observed in 66.7% of cases at stage 2 or 3 and in 88.9% of cases at stage 3. Spine injuries were diagnosed on PMCT in 33.3% of cases prior to autopsy. A significant association was found between spinal hyperostosis and presence of spine injury that cannot be detected on PMCT, indicating that the identification of spinal hyperostosis on PMCT may assist in detecting spine injuries. This finding suggests that investigation of the presence of spine injury based on the identification of spinal hyperostosis on PMCT may assist in determining the correct cause of death by autopsy.
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: tooshima@med.akita-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. Electronic address: mitsu-38@ortho.med.kyushu-u.ac.jp.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hayashida
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: mohtani@doc.med.akita-u.ac.jp.
authors.forename: Maki
authors.initials: M
authors.lastname: Ohtani
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: hashimms@med.akita-u.ac.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: satoshi@doc.med.akita-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: kishiyam@doc.med.akita-u.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ishiyama
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: otani@doc.med.akita-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Otani
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: makoto@doc.med.akita-u.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Radiology, Akita University Graduate School of Medicine, Akita 010-0825, Japan. Electronic address: masugawa@doc.med.akita-u.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugawara
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: mimasaka@med.akita-u.ac.jp.
authors.forename: Sohtaro
authors.initials: S
authors.lastname: Mimasaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods; D002423:Cause of Death; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D005151:Facial Injuries / Q000150:complications / Q000209:etiology; D005260:Female; D049429:Forensic Pathology / Q000379:methods*; D006801:Humans; D015576:Hyperostosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013124:Spinal Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D013167:Spondylitis, Ankylosing / Q000150:complications; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications
keywords: Ankylosing spondylitis; Autopsy; Forensic medicine; Multiplanar reformat reconstruction; Postmortem computed tomography; Postmortem examination; Spinal cord injury; Spinal hyperostosis