Spinal fractures: results and experience with computer tomography.

Our results and experience with computer tomography (CT) were analyzed with respect to 41 patients with fresh bone injuries in both the cervicothoracic and the lumbar region of the vertebral column. Besides differentiated representation of the involvement of various parts of the vertebral body, the arch, transverse and spinous processes in 46 fractures, and four luxation fractures, bone fragments were found in the spinal cavity in 12 patients. Two patients displayed spinal bleeding and 3 showed a traumatic vertebral disc protrusion; 5 patients had paravertebral hematomas. Comparison of the CT-verified computer-tomographic fractures with the results of conventional X-ray diagnosis in two planes, as well as partial a.p. or lateral tomography (n = 12), revealed that in 13 patients even the detection of the fracture remained uncertain. Post-traumatic CT investigation (n = 9) showed syringomyelia in 3 patients, dense necrosis in 1 patient, and spinal channel stenoses as well as radicular irritations which could be explained by overshoot bone neogenesis at the intervertebral foramina. New technological developments in CT instruments of the most recent generation (digital radiography, sagittal and coronary image reconstruction) have made CT the most effective method in the diagnosis of spinal trauma. This necessitates a reorientation in the diagnostic procedure in patients with traumatic lesions of the spine.