ORIGINAL SCIENTIFIC REPORT Does MRI of the Thoracolumbar Spine Change Management in Blunt Trauma Patients with Stable Thoracolumbar Spinal Injuries Without Neurologic Deficits? Paul Deramo 1 • Vaidehi Agrawal 2 • Joseph Amos 3 • Nimesh Patel 4 • Henry Jefferson 3 Ó Socie ´te ´ Internationale de Chirurgie 2016 Abstract Background In blunt trauma patients with computed tomography (CT) findings of stable thoracolumbar (TL) spinal injury without neurologic deficits, magnetic resonance imaging (MRI) studies are commonly obtained, though the impact on overall management remains unclear. The indication for MRI in patients with TL injury without neuro- logic deficits continues to remain unclear. Here, we evaluate the role of MRI on clinical management of patients presenting with this diagnosis. Methods After IRB approval, all registry patients from December 2005 to December 2015 with all blunt TL injuries without defects were extracted. General demographics, injury parameters, hospital and ICU length of stay (ILOS/ HLOS), CT/MRI findings, and intervention were collected. Impact of variant ISS in the four groups was corrected by dividing HLOS and ILOS by ISS. The Student’s t test was conducted for statistical analysis. Results Of 613 patients, 236 met the inclusion criteria with average age of 52 ± 23 y, ISS (7 ± 4), HLOS (5 ± 3 days), and ILOS (1 ± 2 days). One hundred and thirty-three patients underwent MRI, and 103 patients underwent CT only. Patients who underwent MRI were no more likely to attain intervention (p \ 0.06) but had longer length of stay relative to ISS (p \ 0.006). Conclusions MRI did not affect rate of intervention though increased HLOS accounting for ISS. CT findings of stability were concordant with MRI findings. Our results suggest that MRI may not affect intervention decisions in blunt trauma patients with CT findings of stable thoracolumbar spinal injury without neurological deficits. Introduction Blunt traumatic injuries to the thoracolumbar spine, whe- ther isolated or part of multi-system trauma, are common occurrences among trauma patients [1]. Historically, plain film imaging of the thoracolumbar spine was the screening modality for detecting spinal injuries. However, in high- volume trauma centers, multi-slice CT scanners have become the routine imaging modality for screening blunt trauma patients with newer software allowing for imme- diate reconstructions of the thoracolumbar spine. In patients with known thoracolumbar spinal injuries on CT imaging and no neurologic deficits, diagnostic thora- columbar MRI is commonly obtained in our institution & Vaidehi Agrawal vaidehiagrawal@mhd.com 1 Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, TX 75208, USA 2 Clinical Research Institute, Methodist Health System, Pavilion III, Suite 168, 1411 N. Beckley Avenue, Dallas 75203, TX, USA 3 Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas 75208, TX, USA 4 Methodist Moody Brain and Spine Institute, Methodist Dallas Medical Center, Dallas 75203, TX, USA 123 World J Surg DOI 10.1007/s00268-016-3841-2