Diagnostic value of 3D CT surface reconstruction in spinal fractures

Our purpose was to evaluate the diagnostic value of three-dimensional (3D) CT surface reconstruction inn spinal fractures in comparison with axial and reformatted images. A total of 50 patients with different CT-proven spinal fractures were analysed retrospectively. Based on axial scans and reformatted images, the spinal fractures were classified according to several classifications as Magerl for the thoraco-lumbar and lower cervical spine by one radiologist. Another radiologist performed 3D CT surface reconstructions with the aim of characterizing the different types of spinal fractures. A third radiologist classified the 3D CT surface reconstruction according to the Magerl classification. The results of the blinded reading process were compared. It was checked to see in which type and subgroup 3D surface reconstructions were helpful. Readers one and two obtained the same results in the classification. The 3D surface reconstruction did not yield any additional diagnostic information concerning type A and B injuries. Indeed, the full extent of the fracture could be easier recognized with axial and reformatted images in all cases. In 10 cases of C injuries, the dislocation of parts of vertebrae could be better recognized with the help of 3D reconstructions. A 3D CT surface reconstruction is only useful in rotational and shear vertebral injuries (Magerl type C injury).