Sensitivity and specificity of ultrasound in spinal trauma in 29 consecutive patients

Abstract

Purpose: Indication for surgery in spine trauma patients depends on the extent of destruction of the spine. Computer-assisted tomography scan (CAT scan) is not suitable to diagnose type B-injuries. Aim of the study was to investigate whether ultrasound is able to detect destruction of the posterior ligament complex (PLC). Methods: Twenty-nine patients were included. The results of ultrasound were compared with magnetic resonance imaging (MRI), CAT scan, X-ray, intraoperative findings. Statistical analysis was carried out by an independent observer. Results: In 27 cases both ultrasound and MRI had the same result. In two cases, ultrasound failed to detect ligamentous injury. The sensitivity of ultrasound was 0.82 (CI 0.48–0.98), its specificity: 1. MRI and Ultrasound findings had a strong positive correlation (phi = 0.85, Cohen’s kappa: 0.85, with 95 % confidence interval 0.65–1) and a high significance (Fischer’s exact test: p < 0.0001). Conclusion: Ultrasound may indicate rupture or integrity of PLC in cases where MRI is missing.