Department of Radiology, Federal University of Sao Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, Brazil.
United Health Group Brasil (UHG), São Paulo, Brazil.
Skeletal Radiol. 2021 Jun;50(6):1065-1079. doi: 10.1007/s00256-020-03668-6. Epub 2020 Nov 9.
The spine is the main stabilizer and load bearer of the axial skeleton. It is also important for the protection of neural structures, such as the spinal cord, nerve roots, and cauda equina. In the healthy skeleton, most injuries are a consequence of high-energy trauma and can lead to severe dysfunction, such as tetraplegia or paraplegia. In order to avoid such disabilities, it is important to recognize details that will guide treatment, and that will determine the necessity or not to have surgery. Familiarity with radiography, CT, and MRI in evaluating spine trauma is necessary, as, in some cases, all three methods will be useful in determining management and surgical planning. The most important factor in determining management in the thoracolumbar spine is the posterior ligamentous complex (PLC). Therefore, familiarity with its anatomy, primary and secondary signs of its injuries, is essential for radiologists in the emergency setting. Spine fractures are a very heterogeneous group of disorders. Management can be both conservative and surgical. It is important for radiologists to be aware of classifications and patterns for these injuries.
脊柱是轴性骨骼的主要稳定器和承重结构。它对于保护神经结构(如脊髓、神经根和马尾神经)也很重要。在健康的骨骼中,大多数损伤是高能创伤的结果,可能导致严重的功能障碍,如四肢瘫痪或截瘫。为了避免这些残疾,重要的是要识别出将指导治疗的细节,并确定是否需要手术。熟悉 X 线摄影、CT 和 MRI 在评估脊柱创伤中的作用是必要的,因为在某些情况下,这三种方法都有助于确定治疗和手术计划。在胸腰椎中决定治疗的最重要因素是后韧带复合体(PLC)。因此,对于急诊放射科医生来说,熟悉其解剖结构、损伤的主要和次要征象至关重要。脊柱骨折是一组非常异质的疾病。治疗可以是保守的也可以是手术的。放射科医生了解这些损伤的分类和模式非常重要。