Abstract
Introduction
In posterior ligamentous complex injury (PLC), surgery is indicated in the treatment algorithms of thoracic and lumbar fractures. That is why its research is of a great importance, taking into consideration the magnetic resonance imaging (MRI), as historical “gold standard.” As the MRI is not always available or at times it is contraindicated, the use of ultrasound is proposed. Our purpose is to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ultrasound to diagnose PLC injuries in thoracic and lumbar fractures.
Patients and Methods
A protocol is designed before the start of the study, being approved by the Ethics Committee, deciding to perform an ultrasound to all of the patients with PLC admitted with fractured thoracic and lumbar spine, between April 2013 and July 2014. Patients with neurological and life-threatening risks were excluded. The ultrasound and MRI reports were performed by different radiologists without knowledge of the results of other studies. The result of the MRI is considered “gold standard,” and in case of operated patients, there were intraoperative findings. Data were analyzed with STATA 12.
Results
A total amount of 56 patients were recruited, with 7 cases of PLC injuries according to our “gold standard.” The ultrasound as diagnostic tool obtained the following results: sensitivity 0.9999 (95% CI, 0.59–1), specificity 0.9608 (95% CI, 0.8603–0.9966), PPV 0.7778 (95% CI, 0.4427–0.9465), and NPV 0.9999 (95% CI, 0.9131–1).
Conclusion
The ultrasound would be useful to diagnose the PLC injuries in thoracic and lumbar fractures.