Accuracy of CT Scan for Detecting Posterior Ligamentous Complex Injury in Traumatic Thoracolumbar Fractures: A Systematic Review and Meta-Analysis.

Abstract

Study DesignA systematic review and meta-analysis.ObjectivesThis systematic review and meta-analysis aim to evaluate the diagnostic accuracy of CT in detecting PLC injuries in traumatic thoracolumbar fractures.MethodsA comprehensive search of PubMed/MEDLINE, Embase, and Web of Science was conducted up to January 2025. Studies were included if they examined the diagnostic validity of CT for PLC injuries compared with MRI with predefined outcomes (true/false positives/negatives). Quality assessment was performed using the QUADAS-2 tool, and statistical analysis involved bivariate binomial regression to generate summary receiver operating characteristic (SROC) curves and pooled estimates of sensitivity and specificity.ResultsEight studies involving 1440 patients were included. The pooled sensitivity and specificity of CT for PLC injury detection were 75% (95% CI: 68 to 80, P = 0.00) and 87% (95% CI: 71 to 95, P = 0.00), respectively. The area under the curve (AUC) from the SROC analysis was 0.81 (95% CI: 0.78 to 0.84), indicating fair diagnostic accuracy. Meta-regression analysis revealed that sensitivity and specificity remained consistent across advanced CT techniques, multiplanar reconstruction, and full MRI protocol, but extensive trauma, CT 16-64 or ≥128 slices, and 3.0 T MRI scanner influenced it. No significant publication bias was detected.ConclusionThis meta-analysis demonstrates that CT has fair diagnostic accuracy for detecting PLC injuries in traumatic thoracolumbar fractures, supporting its clinical utility. Future research should explore integrating advanced imaging technologies to enhance CT's diagnostic precision.