Skeletal Radiology

, Volume 38, Issue 9, pp 887–893 | Cite as

Measurement of spinal canal narrowing, interpedicular widening, and vertebral compression in spinal burst fractures: plain radiographs versus multidetector computed tomography

  • Frank V. BenschEmail author
  • Mika P. Koivikko
  • Martti J. Kiuru
  • Seppo K. Koskinen
Scientific Article



To assess the reliability of measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening in burst fractures in radiography compared with multidetector computed tomography (MDCT).

Materials and methods

Patients who had confirmed acute vertebral burst fractures over an interval of 34 months underwent both MDCT and radiography. Measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening from MDCT and radiography were compared.


The 108 patients (30 female, 78 male, aged 16–79 years, mean 39 years) had 121 burst fractures. Eleven patients had multiple fractures, of which seven were not contiguous. Measurements showed a strong positive correlation between radiography and MDCT (Spearman’s rank sum test: spinal canal narrowing k = 0.50–0.82, vertebral compression k = 0.55–0.72, and interpedicular widening k = 0.81–0.91, all P < 0.05), except for the cervical spine (k = −0.50 to 0.61, with all P > 0.25) and for interpedicular widening in the thoracic spine (k = 0.35, P = 0.115). The average difference in measurements between the modalities was 3 mm or fewer.


Radiography demonstrates interpedicular widening, spinal canal narrowing and vertebral compression with acceptable precision, with the exception of those of the cervical spine.


Spinal fractures Fractures Comminuted Tomography Spiral computed Radiography 


  1. 1.
    Bensch FV, Koivikko MP, Kiuru MJ, Koskinen SK. The incidence and distribution of burst fractures. Emerg Radiol. 2006; 12: 124–129.CrossRefGoogle Scholar
  2. 2.
    Meves R, Avanzi O. Correlation among canal compromise, neurological deficit, and injury severity in thoracolumbar burst fractures. Spine. 2006; 31: 2137–2141.CrossRefGoogle Scholar
  3. 3.
    Hanson JA, Blackmore CC, Frederick AM, Wilson AJ. Cervical spine injury: accuracy of helical CT used as a screening technique. Emerg Radiol. 2000; 7: 31–35.CrossRefGoogle Scholar
  4. 4.
    Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman JR, Mower WR. Distribution and patterns of blunt traumatic cervical spine injury. Ann Emerg Med. 2001; 38: 17–21.CrossRefGoogle Scholar
  5. 5.
    Edwards MJ, Frankema SP, Kruit MC, Bode PJ, Breslau PJ, van Vugt AB. Routine cervical spine radiography for trauma victims: Does everybody need it? J Trauma. 2001; 50: 529–534.CrossRefGoogle Scholar
  6. 6.
    Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop. 1984; 189: 65–76.Google Scholar
  7. 7.
    Hashimoto T, Kaneda K, Kuniyushi A. Relationship between traumatic spinal canal stenosis and neurological deficit in thoracolumbar burst fractures. Spine. 1988; 13: 1268–1272.CrossRefGoogle Scholar
  8. 8.
    Daffner RH, Daffner SD. Vertebral injuries: detection and implications. Eur J Radiol. 2002; 42: 100–116.CrossRefGoogle Scholar
  9. 9.
    Bensch FV, Kiuru MJ, Koivikko MP, Koskinen SK. Spine fractures in falling accidents: analysis of multidetector CT findings. Eur Radiol. 2004; 14: 618–624.CrossRefGoogle Scholar
  10. 10.
    Trivedi JM, Jones R, Hunt A. Spinal trauma: therapy—options and outcomes. Eur J Radiol. 2002; 42: 127–134.CrossRefGoogle Scholar
  11. 11.
    Floyd T. Alpine skiing, snowboarding, and spinal trauma. Arch Orthop Trauma Surg. 2001; 121: 433–436.CrossRefGoogle Scholar
  12. 12.
    Wilcox RK, Boerger TO, Hall RM, Barton DC, Limb D, Dickson RA. Measurement of canal occlusion during the thoracolumbar burst fracture process. J Biomech. 2002; 35: 381–384.CrossRefGoogle Scholar
  13. 13.
    Berlin L. CT versus radiography for initial evaluation of cervical spine trauma: what is the standard of care? AJR Am J Roentgenol. 2003; 180: 911–915.CrossRefGoogle Scholar
  14. 14.
    Kiuru MJ, Koivikko MP, Koskinen SK. Serious horse-riding accidents: imaging findings and evaluation with multi-slice CT. Emerg Radiol. 2003; 9: 213–218.Google Scholar
  15. 15.
    Cassar-Pullicino VN. Spinal Injury: optimising the imaging options. Eur J Radiol. 2002; 42: 85–91.CrossRefGoogle Scholar
  16. 16.
    Dai L. Remodeling of the spinal canal after thoracolumbar burst fractures. Clin Orthop Relat Res. 2001; 382: 119–123.CrossRefGoogle Scholar
  17. 17.
    Saifuddin A, Noordeen H, Taylor BA, Bayley I. The role of imaging in the diagnosis and management of thoracolumbar burst fractures: current concepts and a review of the literature. Skeletal Radiol. 1996; 25: 603–613.CrossRefGoogle Scholar
  18. 18.
    Hauser CJ, Visvikis G, Hinrichs C, et al. Prospective validation of computed tomographic screening of the thoracolumbar spine in trauma. J Trauma. 2003; 55: 228–234.CrossRefGoogle Scholar

Copyright information

© ISS 2009

Authors and Affiliations

  • Frank V. Bensch
    • 1
    Email author
  • Mika P. Koivikko
    • 1
  • Martti J. Kiuru
    • 2
  • Seppo K. Koskinen
    • 1
  1. 1.Helsinki Medical Imaging Center, Department of RadiologyHelsinki University Central Hospital, Töölö Trauma CenterHelsinkiFinland
  2. 2.Suomen Terveystalo Ltd.HelsinkiFinland

Personalised recommendations