Skip to main content
SpringerLink
Log in

MRI and discography in traumatic intervertebral disc lesions

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

In this study we evaluated magnetic resonance imaging (MRI) in trauma patients for assessing traumatised adjacent discs of fractured vertebrae before dorsoventral stabilisation. In a prospective study, MRI of 54 discs was performed with a 1.5-T MRI unit. The preoperative MRI with sagittal T1-W-SE and T2-W-TSE was compared to intraoperative discography, which was carried out on both intervertebral discs adjacent to the fractured vertebrae. Signal alterations, morphological changes in the adjacent discs, fractured vertebrae and associated ligament injuries were evaluated. In 47/54 (87%) of the intervertebral discs, the results of both imaging findings were concordant. The discs adjoining vertebral fractures were normal in 18 cases. Regarding the positive concordant imaging findings, MRI and discography revealed traumatised adjacent cranial and caudal discs in 22 discs. In 7 cases, only the cranial adjacent disc was affected. Moreover, 17 cases of intradiscal bleeding, 13 intraosseous herniations into the fractured vertebrae and 20 anuluar tears were visualised in MRI. Associated ligament injuries were detected in 18 cases. Findings were discordant in eight discs. In six discs, MRI was abnormal, demonstrating signal alterations suggestive of positive imaging findings, whereas discography demonstrated no disc injury. MRI failed to detect disc injury in two discs, whereas discography was positive, showing an irregular intradiscal contrast media distribution. MRI, as a non-invasive method for assessing fractures of the thoraco-lumbar spine, may detect traumatised adjacent intervertebral discs. MRI is superior to intraoperative discography. The performance of MRI of the thoraco-lumbar spine is recommended before dorsoventral stabilisation in trauma patients, as it can reveal additional preoperative information such as fractures, disc and associated ligament injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Young PC, Petersilge CA (1999) MR imaging of the traumatized lumbar spine. Magn Reson Imaging Clin N AM 7:589–602

    PubMed  CAS  Google Scholar 

  2. Morgan S, Saifuddin A (1999) MRI of the lumbar intervertebral disc. Clin Radiol 54:703–723

    Article  PubMed  CAS  Google Scholar 

  3. Qaiyum M, Tyrrell PN, McCall IW, Cassar-Pullicino VN (2001) MRI detection of unsuspected vertebral injury in acute spinal trauma: incidence and significance. Skeletal Radiol 30:299–304

    Article  PubMed  CAS  Google Scholar 

  4. Wilmink JT (1999) MR imaging of the spine: trauma and degenerative disease. Eur Radiol 9:1259–1266

    Article  PubMed  CAS  Google Scholar 

  5. Oner FC, van Gils AP, Dhert WJ, Verbout AJ (1999) MRI findings of thoraco-lumbar spine fractures: a categorisation based on MRI examinations of 100 fractures. Skeletal Radiol 28:433–443

    Article  PubMed  CAS  Google Scholar 

  6. Saifuddin A, Noordeen H, Taylor BA, Bayley I (1996) The role of imaging in the diagnosis and management of thoracolunbar burst fractures: current concepts and a review of the literature. Skeletal Radiol 25:603–613

    Article  PubMed  CAS  Google Scholar 

  7. Petersilge CA, Pathria MN, Emery SE, Masryk TJ (1995) Thoraco-lumbar burst fracture: evaluation with MR imaging. Radiology 194:49–54

    PubMed  CAS  Google Scholar 

  8. Bensch FV, Kiuru MJ, Koivikko MP, Koskinen SK (2004) Spine fractures in falling accidents: analysis of multidetector CT findings. Eur Radiol 14:618–624

    Article  PubMed  Google Scholar 

  9. Linsenmaier U, Krotz M, Hauser C et al (2002) Whole body computed tomography in polytrauma: techniques and management. Eur Radiol 12:1728–1740

    Article  PubMed  Google Scholar 

  10. Van Goethem JWM, Maes M, Özsarlak Ö, Van de Hauwe L, Parizel PM (2005) Imaging in spinal trauma. Eur Radiol 15:582–590

    Article  PubMed  Google Scholar 

  11. Füderer S, Wenda K, Thiem N, Hachenberger R, Eysel P (2001) Traumatic intervertebral disc lesionmagnetic resonance imaging as a criterion for or against intervertebral fusion. Eur Spine 10:154–163

    Article  Google Scholar 

  12. Rommens PM, Weyns F, Van Calenberg F et al (1995) Mechanical performance of the Dick internal fixator: a clinical study of 75 patients. Eur Spine J 4:104–109

    Article  PubMed  CAS  Google Scholar 

  13. Roth R, Wörsdorfer O (1998) Ventrale Fixationsverfahren bei Verletzungen der thorakolumbalen Wirbelsäule. Osteosyn Int 6:150–156

    Google Scholar 

  14. Osti OL, Fraser RD (1992) MRI and discography of annular tears and intervertebral disc degeneration. J Bone Joint Surg Br 74:431–435

    PubMed  CAS  Google Scholar 

  15. Greenspan A, Amparo EG, Gorczyca DP, Montesano PX (1992) Is there a role for discography in the era of magnetic resonance imaging? Prosepective correlation and quantitative analysis of computed tomography-discography in the evaluation of lumbar disc herniations. J Spinal Disord 5:26–31

    Article  PubMed  CAS  Google Scholar 

  16. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201

    Article  PubMed  CAS  Google Scholar 

  17. Hadden WA, Gillespie WJ (1985) Multiple level injuries of the cervical spine. Injury 16:628–633

    Article  PubMed  CAS  Google Scholar 

  18. Henderson RL, Reid DC, Saboe LA (1991) Multiple non-contiguous spine fractures. Spine 16:128–131

    PubMed  CAS  Google Scholar 

  19. Gupta A, El Masri WS (1989) Multi-level spinal injuries. J Bone joint Surg Br 71:692–695

    PubMed  CAS  Google Scholar 

  20. Junila J, Niinimaki T, Tervonen O (1997) Epidural abscess after lumbar discography. A case report. Spine 22:2191–2193

    Article  PubMed  CAS  Google Scholar 

  21. Milette PC, Raymond J, Fontaine S (1990) Comparison of high-resolution computed tomography with discography in the evaluation of lumbar disc herniations. Spine 15:525–533

    Article  PubMed  CAS  Google Scholar 

  22. Flanders AE, Schaefer DM, Doan HY et al (1990) Acute cervical spine trauma: Correlation of MR imaging findings with degree of neurologic deficit. Radiology 177:25

    PubMed  CAS  Google Scholar 

  23. Tarr RW, Drolshagen LF, Kerner TC et al (1987) MR imaging of recent spinal trauma. J Comput Assist Tomogr 11:412–417

    Article  PubMed  CAS  Google Scholar 

  24. Kakitsubata Y, Theodorou DJ, Theodorou SJ et al (2003) Magnetic resonance discography in cadavers: tears of the annulus fibrosus. Clin Orthop 407:228–240

    Article  PubMed  Google Scholar 

  25. Lappalainen AK, Kaapa E, Lamminen A, Laitinen OM, Gronblad M (2002) The diagnostic value of contrast-enhanced magnetic resonance imaging in the detection of experimentally induced annular tears in sheep. Spine 27:2806–2810

    Article  PubMed  Google Scholar 

  26. Sequeiros RB, Klemola R, Ojala R, Jyrkinen L, Vaara T, Tervonen O (2003) Percutaneous MR-guided discography in a low-field system using optical instrument tracking: a feasibility study. J Magn Reson Imaging 17:214–219

    Article  PubMed  Google Scholar 

  27. Wood KB, Schellhas KP, Garvey TA, Aeppli D (1999) Thoracic discography in healthy individuals. A controlled prospective study of magnetic resonance imaging and discography in asymptomatic and symptomatic individuals. Spine 24:1548–1555

    Article  PubMed  CAS  Google Scholar 

  28. von Gumppenberg S, Allgayer B, Vieweg J, Claudi B (1991) Die Validität der Kernspintomographie bei der Beurteilung der traumatisierten Bandscheibe. Langenbecks Arch Chir 376:346–350

    Article  Google Scholar 

  29. Dorsay TA, Helms CA (2002) MR imaging of epidural hematoma in the lumbar spine. Skeletal Radiol 31:677–685

    Article  PubMed  Google Scholar 

  30. Kliewer MA, Gray L, Paver J et al (1993) Acute spinal ligament disruption: MR imaging with anatomic correlation. J Magn Reson Imaging 3:855–861

    PubMed  CAS  Google Scholar 

  31. Oner FC, vd Rijt RH, Ramos LM, Groen GJ, Dhert WJ, Verbout AJ (1999) Correlation of MR images of disc injuries with anatomic sections in experimental thoracolumbar spine fractures. Eur Spine J 8:194–198

    Article  PubMed  CAS  Google Scholar 

  32. Terk MR, Hume Neal M, Fraipont M, Ahmadi J, Coletti PM (1997) Injury of the posterior ligament complex in patients with acute spinal trauma: evaluation by MR imaging. AJR AM J Roentgenol 168:1481–1486

    PubMed  CAS  Google Scholar 

  33. Emery SE, Pathria MN, Wilber RG, Masaryk T, Bohlman HH (1989) Magnetic resonance imaging of posttraumatic spinal ligament injury. J Spinal Disord 2:229–233

    PubMed  CAS  Google Scholar 

  34. Grenier N, Greselle J-F, Vital J-M et al (1989) Normal and disrupted lumbar longitudinal ligaments: correlative MR and anatomic study. Radiology 171:197–205

    PubMed  CAS  Google Scholar 

  35. Haba H, Taneichi H, Kotani Y et al (2003) Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures. J Neurosurg 99:20–26

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Nadir Ghanem, Markus Uhl, Florian Elgeti, Gregor Pache, Elmar Kotter & Mathias Langer

  2. Traumatology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Christoph Müller & Max Markmiller

Authors
  1. Nadir Ghanem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Markus Uhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christoph Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Florian Elgeti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gregor Pache
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elmar Kotter
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Max Markmiller
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mathias Langer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nadir Ghanem.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ghanem, N., Uhl, M., Müller, C. et al. MRI and discography in traumatic intervertebral disc lesions . Eur Radiol 16, 2533–2541 (2006). https://doi.org/10.1007/s00330-006-0310-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-006-0310-6

Keywords

Search

Navigation