DIAGNOSIS OF THE CONDITION OF OSTEOLIGAMENT COLUMN ELEMENTS IN THORACOLUMBAR SPINE INJURY

Abstract

Objective. To analyze the diagnostic ability of radiologic methods for detecting changes in the middle osteoligament column caused by thoracolumbar spine injuries.

Material and Methods. Seventeen patients aged 21-45 years with compression and comminuted compression fractures of the thoracic and lumbar vertebrae were examined. The insertion of puncture needle into the frontal epidural space was performed under fluoroscopic (on the operating table) or CT control in accordance with the author’s method. Ultravist 240 at a dose of 2-3 ml was used as a contrast medium.

Results. Radiopaque medium filled the loose-tissue space between the posterior longitudinal ligament and the posterior part of the vertebral body. When the integrity of the ligament attached to the adjacent discs was preserved, only the existing space was contrasted. When the ligament was damaged, its disinsertion from the disc or bone fragment was revealed. The contrast medium enveloped a bone fragment retropulsed into the spinal canal, identified individual vessels or anterior venous plexus and anterior epidural hematoma, and visualized the signs of injury to spinal motion segment.

Conclusion. The contrast enhancement of the anterior epidural space of the spinal canal complements existing methods of radiologic diagnostics and allows more accurate assessment of traumatic changes in the elements of the middle osteoligament column of the spine, thus permitting to solve the issues of surgical treatment.