AOSpine Global Survey: International Trends in Utilization of Magnetic Resonance Imaging/Computed Tomography for Spinal Trauma and Spinal Cord Injury across AO Regions. J Neurotrauma 2019 Dec 15;36(24):3323-3331
Date
05/30/2019Pubmed ID
31140387DOI
10.1089/neu.2019.6464Scopus ID
2-s2.0-85075961658 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
The aim of this study was to determine the current trends in magnetic resonance imaging (MRI)/computed tomography (CT) utilization for spine trauma in various clinical scenarios. We conducted a survey across six AO regions and preformed pair-wise comparisons between responses obtained from different AO regions. The survey was sent to 5813 surgeons and had a 9.6% response rate with the majority being orthopedic followed by neurosurgeons. In a neurologically intact patient, the predominant imaging modality for all AO regions was CT. For patients with spinal cord injury (SCI), the predominant choice for all AO regions was CT + MRI + x-ray except North America, which was CT + MRI; pair-wise comparisons revealed significant differences involving LATAM (Latin America) versus (Asia-Pacific [APAC], Europe [EU], and Middle East [MEA]) and APAC versus (LATAM and North America [NA]). In a patient with incomplete SCI (ISCI) who presented within 4 h and had CT, the predominant choice for all AO regions was "forgo MRI and proceed to operating room (OR)." Similar to ISCI, in a patient with complete SCI, the predominant option for all AO regions was the same as ISCI, but the range was lower. Pair-wise comparisons noted significant differences between MEA and APAC, with both exhibiting differences compare to NA, LATAM, and EU for complete and ISCI. Most AO regions obtained post-operative MRI only if there was a new deficit. In summary, decisions about the use of a particular imaging modality across AO regions appears to be influenced by the neurological status of the patient upon admission and the presence of neurological deficits post-surgery. Type of residency training and fellowship training did not have an influence on choosing the appropriate imaging modality for both intact and impaired patients. Further study is needed to determine whether accessibility to MRI would change surgeons' attitude toward obtaining MRI in patients with SCI.
Author List
Shabani S, Kaushal M, Soliman HM, Nguyen HS, Aarabi B, Fehlings MG, Kotter M, Kwon BK, Harrop J, Kurpad SNAuthors
Shekar N. Kurpad MD, PhD Sr Associate Dean, Professor in the Neurosurgery department at Medical College of WisconsinSaman Shabani MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Global HealthHumans
Internationality
Magnetic Resonance Imaging
Spinal Cord Injuries
Spinal Fractures
Surgeons
Surveys and Questionnaires
Tomography, X-Ray Computed
