MR Imaging Characteristics And Clinical Significance Of Vertebral Disc Adjacent To Thoracolumbar Fracture

Objective:To evaluate the mid and short term changes of vertebral disc adjacent to thoracolumbar burst fracture and summarize its imaging characteristics and clinical significance on MRI.Methods:The MRI data of 25 patients with thoracolumbar fracture in the Second Hospital of Shanxi Medical University from May 2020 to May 2021 were collected,including 17 males and 8 females.The age ranged from 29 to 56 years,with an average of 41.08±7.10 years.There were 2 T11 fractures,3 T12 fractures,12 L1 fractures and 8 L2 fractures.MRI data were recorded before surgery and one week before internal fixation removal(internal fixation was removed at an average of 10 months).Morphological characteristics and signal changes of 50 intervertebral discs adjacent to the fractured vertebral body were observed on T2 WI,and their characteristics were summarized.Visual analogue scale(VAS)and The Oswestry Disability Index(ODI)were compared after surgery and removal of internal fixation.Results:86% of the 21 discs with normal signal on T2 WI prior to reduction showed normal signal when the implants were removed;Of the 19 discs with increased signal intensity on T2 WI prior to treatment,42% returned to normal at the time of removal,16% had high signal intensity,26% had decreased signal intensity,and 16% had disc signal loss;Of the 10 discs with decreased signal on T2 WI before reduction,only 1 disc returned to normal upon removal and internal fixation.In 19 form complete intervertebral disc(Category 1),a total of 79% of the intervertebral disc has kept its structural integrity,slightly at 29 defect of intervertebral disc(Category 2),only 2 case after remove the internal fixation of form back to the category 1,62% of the intervertebral disc remains the same,31% of the intervertebral disc structure deterioration(Category 3).Paired sample Wilcoxon test was performed on VAS and ODI scores after reduction surgery and removal of internal fixation,and the results showed P < 0.05,both have statistical differences.Conclusion:Some patients with thoracolumbar fracture will have intervertebral disc injury.Clinically,the changes of intervertebral disc signal and shape on MRI can be taken as one of the important reference factors in the selection of treatment;If the signal and shape of the disc are intact or slightly changed,the VAS and ODI score are better,simple posterior distraction reduction and internal fixation is feasible;If serious morphological changes occur on the basis of changes in intervertebral disc signals,the VAS and ODI scores of such patients will be worse after the removal of internal fixation,and complications such as kyphosis may occur in the long term.Therefore,fusion surgery should be considered as appropriate.