[Significance of double-oblique multiplanar reconstruction of the treatment decision-making in sacral fracture with sacral neurological damage].

OBJECTIVE

To study diagnostic and surgical significance of the multiplanar reconstruction (MPR) of spiral CT in sacral fracture with sacral neurological damage.

METHODS

From April 2007 to April 2009, 10 cases of sacral fracture with sacral neurological damage in Shengjing Hospital of China Medical University were examined by double-oblique MPR of sacrum to show a total length of the sacral neural tube, and observe the course of sacral neural tube and the relationship between fracture and the neural tube. There were 7 males and 3 females, aged 30 - 55 years. The time from injury to hospitalization varied from 1 day to 1 months. The injury was caused by traffic accident in 6 cases, smash of heavy object in 3 cases and crush in 1 cases. All patients were examined with double-oblique MPR (coronal oblique 45 degrees and 30 degrees oblique-shaped bit lost)to display the course of sacral neural tube and the condition of clearly, which was confirmed by operation and clinical validation.

RESULTS

The clinical manifestations and international standards for Neurological Classification of Spinal Cord Injury recommended by American Spinal Injury Association International Spinal Cord Society were the basis for clinical diagnose. Nerve injury diagnosed by clinical manifestation were S1 (6 cases), S2 (2 cases), S1 and S2 (2 cases). After double-oblique MPR in patients, we found 3 patients have fractures in sacral neural tube of S1, 1 patients in S2, and 2 patients both in S1 and S2, whom recovered average 12 month after operation (S1 and S2 nerve were pressed by fractures according to operating observation); And there were no fractures in sacral neural tube of other patients (3 cases in S1, 1 cases in S2), these were contund, whom were recovered average 13 month after expectant treatment.

CONCLUSIONS

Double-oblique MPR of sacrum has important clinical significance in diagnosis of nature and location with sacral nerve injury, as well as surgical planning. It can be used as routine examination of patients with sacral fracture.