An analysis of the correlation between CT images and clinical findings in spinal trauma patients

Computed tomography (CT) is an accurate and safe method of diagnostic imaging in spinal trauma patients. The purpose of the study was to analyze correlations between CT appearance of spine injuries and clinical findings. CT was performed in 193 patients after spinal trauma. In 166 cases (86%) neurological disturbances were present, including 77 (39.9%) patients with signs of spinal cord injury, and 48 (24.9%) with radicular symptoms. Correlations between the clinical findings and the results of CT examinations were analyzed. CT revealed pathological changes in 156 patients (80.8 %). Fractures were found in 128 (66.3%) cases, facet joint injuries in 57 (29.5%), and intervertebral disc lesions in 24 (12.4%) patients. Statistical analysis showed a significant correlation between local pain, as well as minor and transient neurological signs, and normal CT appearance (p<0.05). In patients with radicular symptoms there were positive correlations with intervertebral disc injuries (p<0.001) and degenerative stenosis (p<0.05), while negative correlations with facet joint injuries (p<0.001) and normal CT appearance (p<0.05). Symptoms of spinal cord injury correlated positively with facet joint injuries (p<0.001) while negatively with normal CT appearance and intervertebral disc injuries (p<0.05). Consciousness disturbances correlated positively with brain injuries (p<0.001) and normal CT appearance of the spine (p<0.05), while negatively with the spinal fractures (p<0.05). There is a high correlation between CT results and severity of neurological state of spinal trauma patients. CT should be performed in patients with signs of spinal cord injury as well as in adult patients with radicular symptoms in lumbar spine region. Patients with local pain and minor or transient neurological disturbances should not be examined by CT. There are also no indications to simultaneous CT study of the head and the spine in unconscious patients, unless the kind of trauma, clinical findings or spine X-ray appearance suggest otherwise. (author)