The researchers recorded intraoperative findings for 21 acute spinal trauma patients and 14 non-traumatic spine surgery patients in a control group. There were preoperative MRIs evaluated randomly and blindly by two neuroradiologists.
The researchers found:
1. In detecting injury to the anterior longitudinal ligament, the MRI had 100 percent sensitivity and specificity.
2. There was moderate sensitivity — 80 percent — for patients with injury to the posterior longitudinal ligament. But those images were highly specific at 100 percent.
3. For detecting paraspinal muscles, the MRI was highly sensitive at 100 percent but less specific, at 77 percent.
4. For the intervertebral disc, sensitivity was 100 percent and specificity was 71 percent.
5. For the interspinous ligament, the MRI had 100 percent sensitivity and 64 percent specificity.
6. The MRI was moderately sensitive — 80 percent — and specific — 86.7 percent for detecting ligamentum flavum injury.
7. The MRI was poorly sensitive — 62.5 percent — for identifying facet capsule injury.
“On the basis of these results, we would consider MRI to be a useful tool for spine clearance after trauma,” concluded the study authors. “Conversely, caution should be applied when using MRI for operative decision making due to its less predictable specificity.”
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