Affiliation:
1. Department of Radiology, Tianjin Hospital, Tianjin, China
2. Department of Radiology, The Fifth Centre Hospital of Tianjin City, Tianjin, China
3. Department of Pelvic Trauma, Tianjin Hospital, Tianjin, China
Abstract
BACKGROUND: The treatment of sacral fractures accompanied by nerve injury is complex and often leads to an unsatisfactory prognosis and poor quality of life in patients. OBJECTIVE: The present study aimed to investigate the clinical value of using 3.0T magnetic resonance contrast-enhanced three-dimensional (MR CE-3D) nerve view magnetic resonance neurography (MRN) in the diagnosis and management of a sacral fracture accompanied by a sacral plexus injury. METHODS: Thirty-two patients with a sacral fracture accompanied by a sacral plexus injury, including 24 cases of Denis spinal trauma type II and 8 cases of type III, were enrolled in the study. All patients had symptoms or signs of lumbosacral nerve injury, and an MRN examination was performed to clarify the location and severity of the sacral nerve injury. Segmental localization of the sacral plexus was done to indicate the site of the injury as being intra-spinal (IS), intra-foraminal (IF), or extra-foraminal (EF), and the severity of the nerve injury was determined as being mild, moderate, or severe. Surgical nerve exploration was then conducted in six patients with severe nerve injury. The location and severity of the nerve injury were recorded using intra-operative direct vision, and the results were statistically compared with the MRN examination results. RESULTS: MRN showed that 81 segments had mild sacral plexus injuries (8 segments of IS, 20 segments of IF, 53 segments of EF), 78 segments had moderate sacral plexus injuries (8 segments of IS, 37 segments of IF, and 33 segments of EF), and 19 segments had severe sacral plexus injuries (7 segments of IS, 9 segments of IF, and 3 segments of EF). The six patients who underwent surgery had the following intra-operative direct vision results: 3 segments of moderate injury (IF) and 20 segments of severe injury (7 segments of IS, 10 segments of IF, 3 segments of EF). There was no statistically significant difference in the results between the intra-operative direct vision and those of the MRN examination (p> 0.05). CONCLUSION: MR CE-3D nerve view can clearly and accurately demonstrate the location and severity of sacral nerve injury accompanied by a sacral fracture, and has the potential for being the first choice of examination method for this kind of injury, which would be of important clinical value.
Subject
Health Informatics,Biomedical Engineering,Information Systems,Biomaterials,Bioengineering,Biophysics
Reference30 articles.
1. Incidence of sacral fractures and in-hospital postoperative complications in the United States: an analysis of 2002-2011 data;Bydon;Spine (Phila Pa 1976),2014
2. Progress in surgical treatment of unstable sacral fractures;Gao;Chinese Journal of Orthopaedic Trauma.,2017
3. Surgical treatment of complex Denis zone III sacral fractures;Xie;Chinese Journal of Orthopaedic Trauma.,2018
4. Lumbopelvic Fixation and Sacral Decompression for U-shaped Sacral Fractures: Surgical Management and Early Outcome;Xie;Curr Med Sci.,2018
5. Sacral fractures: an important problem;Denis;Retrospective analysis of 236 cases,1988
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献