CT better than plain radiographs in diagnosing lumbar spine fractures

Lumbar spine fractures in a majority of patients with trauma can be detected by routine trauma abdomen and pelvis CT compared to plain radiographs, according to a recent study conducted by radiologists at the University of Cincinnati in Cincinnati, OH.

The study consisted of 932 patients who underwent plain radiographs and abdomen and pelvis CT within three days of an injury. These patients were divided into groups of: with lumbar spine fracture and without lumbar spine fracture.

According to the study, 180 (19.3%) of the patients had a fracture of the lumbar spine, diagnosed by either modality. Of the 180 patients, CT was positive for fracture in 165 (91.7%) while the plain films were positive for 101 out of 180 patients (56.4%).

The study found that 8.3% of the fractures were missed by CT while 43.9% were missed by plain film. Of that 8.3% (15) that were missed by CT, 11 represented compression deformities of indeterminate age, three were possible transverse process fractures and one was a superior end plate fracture.

"The results of our study determined that lumbar spine radiographs did not provide additional information in trauma patients who underwent abdomen and pelvis CT with lateral scout," said Sangita Kapur, MD, lead author of the study. "If our results are applied to clinical practice and lumbar spine plain films are not routinely obtained, it will help save critical time for these patients and also save valuable resources. Unnecessary radiation exposure can also be avoided," she said.

The full results of this study were presented during the American Roentgen Ray Society's annual meeting in Orlando, FL.