The value of computed tomography in spinal injuries

We studied 71 consecutive patients with spinal injuries by multiplane computed tomography (CT). In fracture-dislocation of 10 patients, displaced vertebrae indicated double marginal sign in transaxial image. In fractures of 20 patients, CT was effective method for demonstrating bony encroachment into the canal and severity of fractures. We divided burst fractures in thoracolumbar region mainly into two types by CT scan in transaxial plane image. In one of them, free body fragments projected into full area of the body posteriorly and plane radigraphy demonstrated that the bilateral adjacent discs were damaged. In the other type, free fragments projecting into the canal were limited in upper half of the body and distally fracture line of the lamina and body was in the same direction. In later plain radiography indicated that the damaged disc was limited in one side. In 10 patients with no significant radiographic evidence of injury, CT scan demonstrated swelling of the cord after gas myelography. CT scan was useful in cases with spinal instrumentation. CT scan was a safe method for evaluating patients with spinal injuries in acute phase. (author)