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Reformatted images of the thoracic and lumbar spine following CT of chest, abdomen, and pelvis in the setting of blunt trauma: are they necessary?

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Abstract

Injuries involving the thoracic and lumbar (TL) spine in the setting of blunt trauma are not uncommon. At our institution, CT of the chest, abdomen, and pelvis (CT CAP) with dedicated reformatted images of the thoracolumbar spine (CT TL) is part of the standard work-up of patients following significant blunt trauma. The purpose of this study was to compare the detection rate of TL spine fractures on routine trauma CT CAP with reformatted CT TL spine images and determine whether these reformatted images detect additional fractures and if these altered patient management. The imaging records of 1000 consecutive patients who received blunt trauma protocol CT CAP with CT TL spine reformats were reviewed to determine identification of TL spine fracture in each report. Fracture type and location were documented. Of the 896 patients, 66 (7.4 %) had fractures of the TL spine identified on either CT CAP or CT TL spine. Of these 66 patients, 40 (60.6 %) had fractures identified on both CT CAP and CT TL spine and 24 (36.4 %) had fractures identified on CT TL spine images alone. Fourteen patients required treatment with surgery or bracing, 4 (28.6 %) of which had fractures identified on reformatted TL spine imaging only. In conclusion, a significant number of fractures are detected on TL spine reformats that are not identified on CT CAP alone, altering patient management in a few cases and suggesting that dedicated TL spine reformats should be a standard part of the work-up of blunt trauma patients.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202, USA

    Britton Carter, Brent Griffith, Feras Mossa-Basha, Suresh Patel & Todd R. Williams

  2. Department of Radiology, William Beaumont Hospital, 3601 W. Thirteen Mile Road, Royal Oak, MI, 48073, USA

    Stephen A. Zintsmaster

  3. Department of Surgery, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202, USA

    Pat Patton

  4. Department of Emergency Medicine, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202, USA

    Phyllis A. Vallee

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  1. Britton Carter
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  2. Brent Griffith
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  3. Feras Mossa-Basha
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  4. Stephen A. Zintsmaster
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  5. Suresh Patel
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  6. Todd R. Williams
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  7. Pat Patton
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  8. Phyllis A. Vallee
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Correspondence to Brent Griffith.

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Carter, B., Griffith, B., Mossa-Basha, F. et al. Reformatted images of the thoracic and lumbar spine following CT of chest, abdomen, and pelvis in the setting of blunt trauma: are they necessary?. Emerg Radiol 22, 373–378 (2015). https://doi.org/10.1007/s10140-015-1295-8

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  • DOI: https://doi.org/10.1007/s10140-015-1295-8

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