Trauma of the Spine: CT and MRI

ISBN-13: 9783642456688 / Angielski / Miękka / 2012 / 90 str.

Berthold Wimmer; Erich Hofmann; Augustinus L. H. Jacob

Opis

Primary reconstructive surgery is assuming increasing importance in the management of fractures of the spine. Analysis of the injury and thus surgical decision-making are greatly facilitated by the diagnostic power of CT and MRI. This volume provides a systemic introduction to the interpretation of CT and MRI images of injuries to the spinal column and the spinal cord, with special emphasis on the assessment or residual stability. Since survey X-rays remain the indispensable first step in radiodiagnosis, the typical appearances of spinal injuries on conventional films are also shown. This will help the reader interpret the CT and MRI images and also reflects the procedure in radiologic practice. The books classification of spinal fractures, together with the attempt to conclude how the injury happened by analyzing the damage caused, paves the way for individually oriented therapy.

Spis treści

1 Basic Considerations.- A. Epidemiology and Statistics.- B. Descriptive and Sectional Anatomy.- I. Bones.- II. Ligaments and Articulations.- III. Spinal Cord and Meninges.- C. Biomechanical Aspects, Stability and Fracture Classification.- I. Some Physical Properties of the Elements of the Spine.- 1. Bony Structures.- a) The Vertebral Body.- b) The Articular Process.- 2. Disko-ligamentous Structures.- a) The Intervertebral Disk.- b) The Ligaments.- 3. The Motion Segment.- 4. The Rib Cage.- 5. The Muscles.- 6. The Spinal Cord.- II. Stability and Fracture Classification.- 1. Conclusion.- D. Neurologic Symptoms in Spinal Trauma.- I. Spinal Shock and Acute Cervical Spinal Cord Syndrome.- II. Complete Spinal Cord Injury.- III. Incomplete Spinal Cord Injury.- IV. Nerve Root Injury.- V. Late Sequelae of Spinal Cord Injury.- E. Advantages and Limitations of the Methods.- I. Computed Tomography.- 1. Performing the Examination.- 2. Scout View.- 3. Transverse Scan.- 4. Secondary Image Reconstruction.- 5. Further Diagnostic Measures.- 6. Limitations of CT Diagnosis.- a) The Diagnostic Gap.- b) Period of Investigation.- c) Artifacts.- d) Resolution.- e) Diagnostic Limitations.- II. Magnetic Resonance Imaging.- 1. Performing the Examination.- 2. Pulse Sequence Considerations.- 3. Advantages and Limitations of MRI.- 2 Bone Injuries.- A. The Cervical Spine.- I. Dislocation and Subluxation.- 1. Atlanto-occipital Dislocation.- 2. Atlanto-axial Dislocation.- a) Anterior and Posterior Atlanto-axial Dislocation.- b) Rotational Atlanto-axial Dislocation.- II. Fractures of the Atlas and Axis.- 1. Fractures of the Atlas.- 2. Fractures of the Ring of the Axis.- 3. Fractures of the Odontoid Process.- III. The Cervical Spine C3-C7.- 1. Whiplash Injury.- 2. Unilateral Dislocation.- 3. Bilateral Dislocation.- 4. Fractures of the Articular Pillar and Posterior Arch.- a) Fracture of the Articular Pillar.- b) Fracture of the Articular Process.- c) Isolated Fracture of the Lamina.- 5. Burst Fracture.- 6. Fracture-Dislocation.- B. The Thoracolumbar Spine.- I. Wedge Compression Fracture.- II. Stable Burst Fracture.- III. Unstable Burst Fracture.- IV. Distraction Injury.- V. Flexion-Distraction Injury.- VI. Fracture — Dislocation.- 1. Dislocation.- 2. Fracture-Dislocation.- 3. Slice Fracture.- 4. Rotational Fracture-Dislocation.- 3 Injuries of the Intervertebral Disk and Neural Tissues.- A. Injuries of the Intervertebral Disk.- B. Accompanying Injuries of the Neural Tissues and Their Coverings.- I. Dura Mater.- II. Nerve-root Avulsion.- III. Epidural Hematoma.- IV. Subarachnoid Hemorrhage.- V. Soft Tissues.- VI. Spinal Cord.- A. Diagnostic Procedure.- I. General Rules.- II. Efficacy of Imaging Methods in Spinal Trauma.- 1. Plain Film.- 2. Functional Examination.- 3. Computed Tomography.- 4. Magnetic Resonance Imaging.- 5. Myelography.- III. Sequence of Examinations.- 1. Diagnostic Imaging in Elective Treatment.- 2. Diagnostic Imaging in Urgent Treatment.- 3. Diagnostic Imaging in Life-threatening Lesions.- References.