title: Does MRI of the Thoracolumbar Spine Change Management in Blunt Trauma Patients with Stable Thoracolumbar Spinal Injuries Without Neurologic Deficits?
abstract: In blunt trauma patients with computed tomography (CT) findings of stable thoracolumbar (TL) spinal injury without neurologic deficits, magnetic resonance imaging (MRI) studies are commonly obtained, though the impact on overall management remains unclear. The indication for MRI in patients with TL injury without neurologic deficits continues to remain unclear. Here, we evaluate the role of MRI on clinical management of patients presenting with this diagnosis.
  
  
  
  After IRB approval, all registry patients from December 2005 to December 2015 with all blunt TL injuries without defects were extracted. General demographics, injury parameters, hospital and ICU length of stay (ILOS/HLOS), CT/MRI findings, and intervention were collected. Impact of variant ISS in the four groups was corrected by dividing HLOS and ILOS by ISS. The Student's t test was conducted for statistical analysis.
  
  
  
  Of 613 patients, 236 met the inclusion criteria with average age of 52 ± 23 y, ISS (7 ± 4), HLOS (5 ± 3 days), and ILOS (1 ± 2 days). One hundred and thirty-three patients underwent MRI, and 103 patients underwent CT only. Patients who underwent MRI were no more likely to attain intervention (p < 0.06) but had longer length of stay relative to ISS (p < 0.006).
  
  
  
  MRI did not affect rate of intervention though increased HLOS accounting for ISS. CT findings of stability were concordant with MRI findings. Our results suggest that MRI may not affect intervention decisions in blunt trauma patients with CT findings of stable thoracolumbar spinal injury without neurological deficits.
authors.affiliation: Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, TX, 75208, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Deramo
authors.affiliation: Clinical Research Institute, Methodist Health System, Pavilion III, Suite 168, 1411 N. Beckley Avenue, Dallas, 75203, TX, USA. vaidehiagrawal@mhd.com.
authors.forename: Vaidehi
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, 75208, TX, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Amos
authors.affiliation: Methodist Moody Brain and Spine Institute, Methodist Dallas Medical Center, Dallas, 75203, TX, USA.
authors.forename: Nimesh
authors.initials: N
authors.lastname: Patel
authors.affiliation: Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, 75208, TX, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Jefferson
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012042:Registries; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*