Magnetic resonance tomography for the early detection of occult fractures of the spinal column in patients with ankylosing spondylitis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-01-29

AUTHORS

Nicolas H. von der Höh, Jeanette Henkelmann, Jan-Sven Jarvers, Ulrich Josef A. Spiegl, Anna Voelker, Christoph Josten, Christoph-Eckhard Heyde

ABSTRACT

PurposeThe purpose of this study was to determine the extent to which magnetic resonance imaging (MRI) performed in patients with ankylosing spondylitis (AS) after low- and no-energy trauma leads to an improved diagnosis and, as a result, to a change in the therapeutic strategy.MethodsAll patients with AS, who underwent surgery after minor traumas (low-energy traumas, LETs) and patients without trauma history (NET: no-energy trauma), were retrospectively analysed. The diagnostic and planned surgical procedure was examined initially and again after total spine MRI in patients with persistent and/or new complaints.ResultsOne hundred and thirty-six patients with AS after trauma were surgically treated. A total of 92 patients with LETs and 12 patients with NETs were included. After initial diagnostics (CT and X-ray) were performed in 15.4% of the patients with LET or NET (n = 16), we found occult fractures on MRI scans. In ten of these patients (6 LET, 4 NET) in which a previous decision was made to follow conservative therapy, no fracture indication was found on CT or X-ray. Two fracture heights were observed in six patients who experienced LET. However, on X-ray and CT, the fractures were only visible at one height. All fractures were treated surgically with stabilization and decompression if indicated.ConclusionConsidering the high percentage of our patient population with occult fractures, we recommend supplementing the basic diagnostic procedures with an MRI of the entire spinal column in patients with painful spinal column findings after minor trauma and for those with persistent pain without trauma.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material. More... »

PAGES

870-878

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00586-020-06309-7

DOI

http://dx.doi.org/10.1007/s00586-020-06309-7

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https://app.dimensions.ai/details/publication/pub.1124365527

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31993791


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