The interrelationship between grade of compression fracture of vertebra in CT scan with intervertebral disk lesion in MRI in patients with acute spinal trauma

Abstract

Vertebral fractures are one of the most common fractures and one of these fractures is a compression fracture. Intervertebral disc damage in axial spine trauma is one of the important points that is usually not taken into account, which not only leads to secondary degenerative changes of the disc, but can also cause clinical symptoms (secondary to edema and bleeding) and compressive effect on the spinal cord in the acute stage. and nerve roots (secondary to herniation). The aim of this study is to determine the relationship between the degree of vertebral compression fracture in CT scan and intervertebral disc lesion in MRI in patients with acute spine trauma. Materials and Methods: In this cross-sectional study, 150 patients were subjected to CT-Scan and MRI of the thoracic or lumbar regions of the spine. All CT-Scan images were performed with a 320-row single-source machine and MRI using a standard 1.5-T imager. Both images were reviewed as soon as they became available. Disc changes on MRI were scored using a semi-quantitative grading system according to the classification of Sander et al. Bone marrow edema was obtained based on MRI findings and was classified as below 1.3, 1.3 to 2.3 and above 2.3 edema. Vertebral compression fracture grade was also evaluated based on CT findings and classified into 4 categories based on the Genant classification. Also, the type of fracture was investigated based on the shape of the fracture and classified as follows. Results: The highest frequency of vertebral compression fracture was grade 1 (52%) followed by grade 2 (40%). The most common disc changes were related to edema (22.7%) followed by hernia (18%). In 56.7% of cases, the intervertebral disc was in normal condition. Most cases of bone marrow edema were graded between 1.3 and 2.3 (50%). The most common fracture morphology was Sub endplate (41.3%). Also, end plate involvement was seen in 63.3% of cases. There was a significant and positive correlation between disc changes related to herniation (p=0.001; R=0.323) and the degree of compression fracture of the vertebra, so that as the degree of fracture increased, the cases of herniation also increased. According to this finding, the sensitivity, specificity, negative and positive predictive value of CT-Scan in predicting hernia according to the degree of fracture greater than and equal to 2 are equal to 81.48%, 59.35%, 93.59% and respectively. 30.56% was obtained. On the other hand, a significant and positive correlation was observed between disc changes related to herniation (p=0.022; R=0.249) and diffuse fracture.