Abstract
Objectives: To evaluate the relationship between computed tomography (CT)-based Vertebral compression fractures (VCFs) severity and intervertebral disc pathology on magnetic resonance imaging (MRI).
Design: A cross-sectional study.
Setting(s): Single-center trauma imaging, Tabriz, Iran.
Participants: A total of 150 consecutive adult patients with acute thoracic or lumbar spine trauma who underwent both CT and MRI examinations.
Outcome measures: VCFs severity graded on CT based on vertebral height loss and fracture morphology; MRI assessment of bone marrow edema extent and intervertebral disc pathology using a semi-quantitative grading system.
Results: Grade 1 VCFs were the most common (52%), followed by grade 2 (40%). Disc abnormalities included edema (22.7%) and herniation (18%), while 56.7% of discs appeared normal. Moreover, bone marrow edema involving one-third to two-thirds of vertebral height was present in nearly half of the cases. In addition, subendplate fractures were the most frequent morphological subtype (41.3%). Furthermore, a VCF grade≥2 predicted MRI-detected disc herniation with a sensitivity of 81.4%, specificity of 59.3%, negative predictive value of 93.5%, and positive predictive value of 30.5%. Ultimately, higher VCF grades were significantly associated with disc herniation and more extensive bone marrow edema.
Conclusions: Overall, higher-grade VCFs on CT are associated with disc herniation and greater marrow edema on MRI in acute spinal trauma. Additionally, CT severity grading may assist in identifying patients who warrant prompt MRI evaluation. However, CT alone should not be used to guide surgical decision-making.