Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with XXXX .

@entity174 @entity1 @entity130
OBJECT: The posterior ligamentous complex (PLC) in the thoracic and lumbar spine is one of the region's important stabilizers. The precise diagnosis of @entity130 is required to evaluate the instability of the injured spine; however, the accuracy of magnetic resonance (MR) imaging for diagnosing @entity130 has remained unclear. In this study, the authors compared preoperative MR imaging findings with direct intraoperative observation of @entity130 , clarifying the former's diagnostic accuracy regarding detection of @entity130 associated with the @entity174 . METHODS: Data obtained in 35 @entity1 who sustained thoracic or lumbar injuries were reviewed. There were 17 burst @entity174 , six flexion-distraction injuries, and 12 @entity174 . Each @entity1 underwent MR imaging examination within 3 weeks of injury. Three radiologists independently evaluated sagittal MR images in a blinded fashion. The PLC-related information was retrospectively collected from each operative record. The diagnostic accuracy of MR imaging was analyzed by comparing imaging-documented intraoperative findings. The @entity130 were detected in 23 @entity1 (65.7%) by direct observation during posterior spinal procedures. The diagnostic accuracy of MR imaging in detecting injury of the supraspinous ligament (SSL) and interspinous ligament (ISL) was 90.5 and 94.3%, respectively. The specificity of T1-weighted MR imaging alone for depicting the SSL was significantly greater than T2-weighted imaging alone (p < 0.05). The overall mean kappa coefficient for MR imaging findings of @entity130 was 0.803, which indicated excellent interobserver reliability; that for ISL (0.915) was significantly greater than that for SSL (0.69) (p < 0.05). CONCLUSIONS: This study clarified a high diagnostic accuracy and interobserver reliability of MR imaging for @entity130 . The precise diagnosis of @entity130 is essential to determine the mechanical instability of the injured thoracic and lumbar spine, especially in differentiating unstable (three-column) burst @entity174 from the relatively stable (two-column) type. The authors conclude that MR imaging is a powerful diagnostic tool to evaluate @entity130 associated with @entity174 .
