CT scans versus conventional tomography in acute fractures of the odontoid process.

Abstract

Four different radiological diagnostic methods were compared as to their diagnostic relevance in the analysis of odontoid fractures. Thirty-one patients with fresh odontoid fractures were investigated using standard anteroposterior and lateral radiographs, conventional tomography, axial computerized tomography and two-dimensional reconstruction in the sagittal and the coronal planes. As a control, 13 patients without odontoid fractures were examined. The results of the different investigations were correlated with the actual (clinical and/or intra-operative) findings. The coefficients of correlation for the conventional tomography and two-dimensional reconstruction were kappa=0.774 and kappa=0.907, respectively. For conventional radiography and axial computerized tomography (CT), the coefficients were clearly lower, at kappa=0.364 and kappa=0.627, respectively. The less time-consuming CT examination with sagittal and coronal reconstructions is equivalent with respect to diagnostic accuracy and can, therefore, replace conventional tomography in the evaluation fractures.