E. Gondo

Operative Findings of Acute Cervical Spine Injuries

We think that injured spine with neurological involvement is unstable in acute phase. From June in 1979 to June in 1982, we treated 75 patients with injured spine by several operative methods within 1 month after trauma. We compared their operative findings with radiographic appearances. The results indicated that (1) Simultaneous anterior and posterior decompression and fusion was necessary in all cases of fracture-dislocations and some of flexion teardrop fractures. (2) Anterior decompression and fusion was indicated for cases of no significant radiographic appearance of injury because of their usual disc damage.

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.