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Abstract

The value of CT in determining potential instability of simple wedge-compression fractures of the lumbar spine.

S E Campbell, C D Phillips, E Dubovsky, W S Cail and R A Omary
American Journal of Neuroradiology August 1995, 16 (7) 1385-1392;
S E Campbell
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C D Phillips
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E Dubovsky
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W S Cail
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R A Omary
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Abstract

PURPOSE To determine whether plain films alone are sufficient in the evaluation of stability of simple wedge-compression fractures of the lumbar spine.

METHODS Plain films and CT scans of 53 consecutive patients seen during a 2-year period with lumbar spine fractures were retrospectively reviewed. Six readers blinded to the CT diagnosis independently read each patient's plain films. Plain-film findings were scored on a five-point graded response scale using criteria proposed by Gehweiler and Daffner. In addition, a fracture was considered to be possibly unstable if there was involvement of more than one vertebral level or greater than 50% loss of anterior vertebral body height. CT findings represented the standard for comparison. CT scans were independently evaluated by three additional readers. Two-column involvement, middle-column involvement alone but with retropulsion, multiple-level involvement, or greater than 50% loss of vertebral height indicated potential instability.

RESULTS For 14 stable and 39 potentially unstable lumbar spine fractures, the pooled (mean) plain-film negative predictive value for detection of potentially unstable fractures was 0.62 (95% confidence interval, 0.53 to 0.70), with a sensitivity of 0.83 (95%, confidence interval; 0.78 to 0.87), and specificity of 0.80 (95% confidence interval, 0.70 to 0.87).

CONCLUSION Plain films are not adequate for determining stability of lumbar spine fractures.

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American Journal of Neuroradiology
Vol. 16, Issue 7
1 Aug 1995
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The value of CT in determining potential instability of simple wedge-compression fractures of the lumbar spine.
S E Campbell, C D Phillips, E Dubovsky, W S Cail, R A Omary
American Journal of Neuroradiology Aug 1995, 16 (7) 1385-1392;

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The value of CT in determining potential instability of simple wedge-compression fractures of the lumbar spine.
S E Campbell, C D Phillips, E Dubovsky, W S Cail, R A Omary
American Journal of Neuroradiology Aug 1995, 16 (7) 1385-1392;
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