Magnetic resonance imaging following spine trauma

▸Magnetic resonance imaging (MRI) is used to assess soft-tissue structures following spine trauma; yet, in order to achieve optimum diagnostic accuracy, interpretation must also consider the patient history, physical examination findings, radiographic findings, and computed tomography (CT) findings. ▸The indications for MRI following spinal trauma include progressive neurological deficit with normal radiographic and CT findings, the presence of a neurological deficit (especially a neurological deficit inconsistent with the fracture level), and prior to surgical stabilization in the setting of a facet dislocation. MRI also may be considered for the assessment of obtunded patients and neurologically intact patients with the possibility of instability or facet subluxation-dislocation (relative indications). ▸Moderate concordance exists between MRI and intraoperative findings, and care should be taken to avoid overdiagnosis of injury to the posterior ligamentous complex structures, particularly in patients with minimal or no neurological deficit. ▸Several issues concerning the utility of MRI findings following spine trauma remain debatable. Clinicians should plan the most prudent strategy on the basis of an individualized approach.