Hospital: Hospital Clínico Universitario Virgen de la Arrixaca.
Ciudad:
Nº:
Aut@r o Autores: M. Martínez Cutillas, D. Gea Martos, I. Sánchez-Serrano, M. Ato González, P. Rey Segovia, C. Fernández-Hernández.,
Presentación:
A 23 years-old male who presented acute paraparesis and D6 sensory level after a motorcycle accident. The column CT performed D5 burst fracture with displacement of a bony fragment into the spinal canal was revealed. Also, a spinal cord MRI was performed in emergency department. This test showed spinal cord discontinuity and thick high T2 signal intramedullar extended beyond D4-D5. These findings are attributable to spinal cord contusion, cord swelling and spinal cord transection.Urgent surgery was required with posterior short segment (D3-D6) fixation with pedicle screws and rods. After his stabilization, the patient was transferred to a paraplegic hospital to receive specials cares.
Discusión:
Traumatic injuries of the spine and spinal cord are common and potentially devastating lesions. There is growing evidence that imaging techniques provide answers to some of the key questions in the management of patients with spine and spinal cord trauma. They give information about lesion etiology (malignant or benign), degree of cord damage and, in case of fracture about its stability and stage of evolution (acute or chronic). For all this, a high-quality radiological investigation is essential in the diagnosis and management of patients with spinal trauma.One of the consequences of spinal trauma is the spinal cord transection andit is an important radiological finding that can influence the decision on potential surgery.The clinical features usually involve motor and sensory neurology corresponding to the level of cord injury. Spinal cord damage suspicion is the most frequent cause to perform MRI in an emergency department. TSET1, TSET and STIR in a sagittal plane are the basic sequences to start the spine imaging test. Later, axial plane is done to an accurate evaluation of the spinal cord damage. In addition, susceptibility weighted imaging(SWI) and diffusion-weighted imaging (DWI) sequences can be used to evaluate hemorrhage o edema.
Conclusión:
Traumatic injuries of the spine and spinal cord are common and potentially devastating lesions. There is growing evidence that imaging techniques provide answers to some of the key questions in the management of patients with spine and spinal cord trauma. They give information about lesion etiology (malignant or benign), degree of cord damage and, in case of fracture about its stability and stage of evolution (acute or chronic). For all this, a high-quality radiological investigation is essential in the diagnosis and management of patients with spinal trauma.One of the consequences of spinal trauma is the spinal cord transection andit is an important radiological finding that can influence the decision on potential surgery.The clinical features usually involve motor and sensory neurology corresponding to the level of cord injury. Spinal cord damage suspicion is the most frequent cause to perform MRI in an emergency department. TSET1, TSET and STIR in a sagittal plane are the basic sequences to start the spine imaging test. Later, axial plane is done to an accurate evaluation of the spinal cord damage. In addition, susceptibility weighted imaging(SWI) and diffusion-weighted imaging (DWI) sequences can be used to evaluate hemorrhage o edema.
Bibliografía:
– Parizel PM, van der Zijden T, Gaudino S, Spaepen M, Voormolen MH, Venstermans C, De Belder F, van den Hauwe L, Van Goethem J. Trauma of the spine and spinal cord: imaging strategies. Eur Spine J. 2010 Mar,19 Suppl 1:S817. – Mhuircheartaigh NN, Kerr JM,