The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture
Purposes To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI). Methods One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divi...
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| Veröffentlicht in: | European spine journal 2017-05, Vol.26 (5), p.1454-1462 |
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| creator | Chen, Jiao-Xiang Goswami, Amit Xu, Dao-Liang Xuan, Jun Jin, Hai-Ming Xu, Hong-Ming Zhou, Feng Wang, Yong-Li Wang, Xiang-Yang |
| description | Purposes
To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).
Methods
One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (
A
/
P
ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV).
T
test, Pearson’s Chi-square and multivariate logistic regression were calculated for the variables.
Results
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA 25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm,
P
= 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°,
P
= 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°,
P
= 0.021). The indications for interspinous ligament (ISL) injury included AEIEA |
| doi_str_mv | 10.1007/s00586-016-4687-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1897380516</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4322043263</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-54665d5f54f1c43ea4742256599b91da019644d0d34fd942ee0831dd0e3cd9fd3</originalsourceid><addsrcrecordid>eNqNkU1r3DAQhkVoaDZJf0AvRdBLLm5GsiRbxxLyBYFekrPQWuNdLbblSjbd_feV2SSUQqGnGWaeeTWjl5DPDL4xgOo6AchaFcBUIVRdFfsTsmKi5AXokn8gK9ACClUxfUbOU9oBMKlBfSRnvCrrGjisiH_eIo3W-dCFjW-oTQlT6nGYaGjpGNKE0YdIO7-xSzXMiTahHzvcUz_s5njIgY528rmZ6C8_bem0DdE2oZv7tY20zfk0R7wkp63tEn56jRfk5e72-eahePpx_3jz_aloBMipkEIp6WQrRcsaUaIVleBcKqn1WjNngWklhANXitZpwRGhLplzgGXjdOvKC3J11B1j-DljmkzvU4NdZwfM2xtW63w9SKb-A-X592SleEa__oXuwhyHfMgiyGWdt1gE2ZFqYkgpYmvG6HsbD4aBWSwzR8tMtswslpl9nvnyqjyve3TvE28eZYAfgZRbwwbjH0__U_U3aT2i1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1892580836</pqid></control><display><type>article</type><title>The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, Jiao-Xiang ; Goswami, Amit ; Xu, Dao-Liang ; Xuan, Jun ; Jin, Hai-Ming ; Xu, Hong-Ming ; Zhou, Feng ; Wang, Yong-Li ; Wang, Xiang-Yang</creator><creatorcontrib>Chen, Jiao-Xiang ; Goswami, Amit ; Xu, Dao-Liang ; Xuan, Jun ; Jin, Hai-Ming ; Xu, Hong-Ming ; Zhou, Feng ; Wang, Yong-Li ; Wang, Xiang-Yang</creatorcontrib><description><![CDATA[Purposes
To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).
Methods
One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (
A
/
P
ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV).
T
test, Pearson’s Chi-square and multivariate logistic regression were calculated for the variables.
Results
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm,
P
= 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°,
P
= 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°,
P
= 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (
P
= 0.004 and
P
< 0.001, respectively), increased AED (
P
= 0.010), LK >25° (
P
= 0.024), AVH (
P
< 0.001), and BFOFV (
P
< 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408,
P
= 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494,
P
= 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (
P
= 0.035 and 0.001, respectively) or SSL rupture (
P
= 0.014 and 0.008, respectively).
Conclusion
Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI,
A
/
P
ratio, and AVH ratio are not.]]></description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-016-4687-x</identifier><identifier>PMID: 27388020</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Female ; Humans ; Longitudinal Ligaments - diagnostic imaging ; Longitudinal Ligaments - injuries ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - injuries ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurosurgery ; Original Article ; Retrospective Studies ; Spinal Fractures - diagnostic imaging ; Surgical Orthopedics ; Thoracic Vertebrae - diagnostic imaging ; Thoracic Vertebrae - injuries ; Young Adult</subject><ispartof>European spine journal, 2017-05, Vol.26 (5), p.1454-1462</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Spine Journal is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-54665d5f54f1c43ea4742256599b91da019644d0d34fd942ee0831dd0e3cd9fd3</citedby><cites>FETCH-LOGICAL-c405t-54665d5f54f1c43ea4742256599b91da019644d0d34fd942ee0831dd0e3cd9fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-016-4687-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-016-4687-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27388020$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Jiao-Xiang</creatorcontrib><creatorcontrib>Goswami, Amit</creatorcontrib><creatorcontrib>Xu, Dao-Liang</creatorcontrib><creatorcontrib>Xuan, Jun</creatorcontrib><creatorcontrib>Jin, Hai-Ming</creatorcontrib><creatorcontrib>Xu, Hong-Ming</creatorcontrib><creatorcontrib>Zhou, Feng</creatorcontrib><creatorcontrib>Wang, Yong-Li</creatorcontrib><creatorcontrib>Wang, Xiang-Yang</creatorcontrib><title>The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description><![CDATA[Purposes
To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).
Methods
One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (
A
/
P
ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV).
T
test, Pearson’s Chi-square and multivariate logistic regression were calculated for the variables.
Results
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm,
P
= 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°,
P
= 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°,
P
= 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (
P
= 0.004 and
P
< 0.001, respectively), increased AED (
P
= 0.010), LK >25° (
P
= 0.024), AVH (
P
< 0.001), and BFOFV (
P
< 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408,
P
= 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494,
P
= 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (
P
= 0.035 and 0.001, respectively) or SSL rupture (
P
= 0.014 and 0.008, respectively).
Conclusion
Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI,
A
/
P
ratio, and AVH ratio are not.]]></description><subject>Adult</subject><subject>Female</subject><subject>Humans</subject><subject>Longitudinal Ligaments - diagnostic imaging</subject><subject>Longitudinal Ligaments - injuries</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - injuries</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Spinal Fractures - diagnostic imaging</subject><subject>Surgical Orthopedics</subject><subject>Thoracic Vertebrae - diagnostic imaging</subject><subject>Thoracic Vertebrae - injuries</subject><subject>Young Adult</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1r3DAQhkVoaDZJf0AvRdBLLm5GsiRbxxLyBYFekrPQWuNdLbblSjbd_feV2SSUQqGnGWaeeTWjl5DPDL4xgOo6AchaFcBUIVRdFfsTsmKi5AXokn8gK9ACClUxfUbOU9oBMKlBfSRnvCrrGjisiH_eIo3W-dCFjW-oTQlT6nGYaGjpGNKE0YdIO7-xSzXMiTahHzvcUz_s5njIgY528rmZ6C8_bem0DdE2oZv7tY20zfk0R7wkp63tEn56jRfk5e72-eahePpx_3jz_aloBMipkEIp6WQrRcsaUaIVleBcKqn1WjNngWklhANXitZpwRGhLplzgGXjdOvKC3J11B1j-DljmkzvU4NdZwfM2xtW63w9SKb-A-X592SleEa__oXuwhyHfMgiyGWdt1gE2ZFqYkgpYmvG6HsbD4aBWSwzR8tMtswslpl9nvnyqjyve3TvE28eZYAfgZRbwwbjH0__U_U3aT2i1Q</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Chen, Jiao-Xiang</creator><creator>Goswami, Amit</creator><creator>Xu, Dao-Liang</creator><creator>Xuan, Jun</creator><creator>Jin, Hai-Ming</creator><creator>Xu, Hong-Ming</creator><creator>Zhou, Feng</creator><creator>Wang, Yong-Li</creator><creator>Wang, Xiang-Yang</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture</title><author>Chen, Jiao-Xiang ; Goswami, Amit ; Xu, Dao-Liang ; Xuan, Jun ; Jin, Hai-Ming ; Xu, Hong-Ming ; Zhou, Feng ; Wang, Yong-Li ; Wang, Xiang-Yang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-54665d5f54f1c43ea4742256599b91da019644d0d34fd942ee0831dd0e3cd9fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Female</topic><topic>Humans</topic><topic>Longitudinal Ligaments - diagnostic imaging</topic><topic>Longitudinal Ligaments - injuries</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - injuries</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Spinal Fractures - diagnostic imaging</topic><topic>Surgical Orthopedics</topic><topic>Thoracic Vertebrae - diagnostic imaging</topic><topic>Thoracic Vertebrae - injuries</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Jiao-Xiang</creatorcontrib><creatorcontrib>Goswami, Amit</creatorcontrib><creatorcontrib>Xu, Dao-Liang</creatorcontrib><creatorcontrib>Xuan, Jun</creatorcontrib><creatorcontrib>Jin, Hai-Ming</creatorcontrib><creatorcontrib>Xu, Hong-Ming</creatorcontrib><creatorcontrib>Zhou, Feng</creatorcontrib><creatorcontrib>Wang, Yong-Li</creatorcontrib><creatorcontrib>Wang, Xiang-Yang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Jiao-Xiang</au><au>Goswami, Amit</au><au>Xu, Dao-Liang</au><au>Xuan, Jun</au><au>Jin, Hai-Ming</au><au>Xu, Hong-Ming</au><au>Zhou, Feng</au><au>Wang, Yong-Li</au><au>Wang, Xiang-Yang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>26</volume><issue>5</issue><spage>1454</spage><epage>1462</epage><pages>1454-1462</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract><![CDATA[Purposes
To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).
Methods
One hundred and five thoracolumbar fracture (T11–L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (
A
/
P
ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV).
T
test, Pearson’s Chi-square and multivariate logistic regression were calculated for the variables.
Results
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm,
P
= 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°,
P
= 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°,
P
= 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (
P
= 0.004 and
P
< 0.001, respectively), increased AED (
P
= 0.010), LK >25° (
P
= 0.024), AVH (
P
< 0.001), and BFOFV (
P
< 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408,
P
= 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494,
P
= 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (
P
= 0.035 and 0.001, respectively) or SSL rupture (
P
= 0.014 and 0.008, respectively).
Conclusion
Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI,
A
/
P
ratio, and AVH ratio are not.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27388020</pmid><doi>10.1007/s00586-016-4687-x</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0940-6719 |
| ispartof | European spine journal, 2017-05, Vol.26 (5), p.1454-1462 |
| issn | 0940-6719 1432-0932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1897380516 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Female Humans Longitudinal Ligaments - diagnostic imaging Longitudinal Ligaments - injuries Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - injuries Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Neurosurgery Original Article Retrospective Studies Spinal Fractures - diagnostic imaging Surgical Orthopedics Thoracic Vertebrae - diagnostic imaging Thoracic Vertebrae - injuries Young Adult |
| title | The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture |
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