82. Jahreskongress swiss orthopaedics 2022
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Beitragstitel Complementary Value of CT Scout View in the Recognition of Thoracolumbar Spine Injuries
Beitragscode P17
Autoren
  1. Helena Milavec Schuthess Clinic Vortragender
  2. Vera T Gasser Inselspital, Bern University Hospital, Bern, Switzerland
  3. Thomas Ruder Department of Radiology, Inselspital, University of Bern, Switzerland
  4. Moritz Caspar Deml Inselspital, Universität Bern
  5. Wolf Hautz Department of Emergency Medicine, Inselspital, University of Bern, Switzerland
  6. Aristomenis Exadaktylos Department of Emergency Medicine, Inselspital, University of Bern, Switzerland
  7. Lorin Michael Benneker Ortho-Spine, Sonnenhof Spital
  8. Christoph Emanuel Albers Universitätsklinik für Orthopädische Chirurgie und Traumatologie, Inselspital Bern
Präsentationsform Poster
Themengebiete
  • A03 - Wirbelsäule
Abstract INTRODUCTION

Fractures of the thoracolumbar spine (TLS) are common in polytrauma. Prompt detection of spinal injuries is essential in the early resuscitation phase. Whole-body CT (WBCT) is used as standard diagnostic tool for spinal screening. Each WBCT starts with a CT scout view (SV) to prescribe and display locations of CT slices. Apart from its original purpose, SV may supply complementary information and be of value to operate as a diagnostic tool. There is dearth of literature investigating on the importance of SV in screening the spine. We aimed to investigate the reliability of SV to detect clinically relevant injuries of the TLS.

METHODS

In this retrospective single-center study of prospectively collected data, we reviewed 200 patients undergoing WBCT in early resuscitation phase after trauma, admitted to our tertiary emergency center in 2019. Lateral and AP SV were independently analyzed by two senior spine surgeons and one senior radiologist including Th10-L5. Findings of the raters were compared to CT reconstructions. Fractures were ranked according to AOSpine Classification system. All data analyses were done in the R Language for Statistical Computing. Calculations of diagnostic performance (accuracy, sensitivity, specificity) was carried out using the pROC package. Rater agreement was calculated using Fleiss Kappa as implemented in the irr-package. Univariate and multivariate logistic regressions were estimated using the glm function.

RESULTS

Overall, 39 patients had a fracture within the included region. Of these, N=17 had multiple fractures (range 2-4). In sum, there were 39 mild fractures (type A), 16 were moderate (type B) and 1 severe (type C). The pooled accuracy was 78%. Pooled sensitivity and specificity were 88% and 76%, respectively. For experts’ ability to detect moderate or severe injuries only (type AO B and C), sensitivity was 94%. All raters correctly identified the single type C injury. In cases of the right decision, the average confidence level was 74% for lateral and 65% for AP view.

CONCLUSION

SV review may serve as a valuable tool for early detection of spinal injuries in the TLS before CT constructions are available. Particularly in fractures of type B and C according to AOSpine, our data revealed a high sensitivity in detection and appraisal. SV may accelerate spinal screening in the management of polytrauma patients.