{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:30:33Z","timestamp":1762432233448,"version":"build-2065373602"},"reference-count":16,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Unstable thoracolumbar burst fractures require surgical management as they can result in neurological deficits if left untreated. This study aimed to evaluate whether a new bone scan scoring system could accurately assess instability in thoracolumbar burst fractures. Materials and Methods: Fifty-two patients with thoracolumbar burst fractures who underwent bone scans and magnetic resonance imaging prior to surgery between January 2015 and August 2017 at Ulsan University Hospital were selected for inclusion. Instability was determined by clinical assessment and imaging, and the Thoracolumbar Injury Classification and Severity score was determined. Bone scans were visually evaluated using a new bone scan scoring system. Bone scan findings of vertebral body (BB) and posterior column (BP) were scored separately and were summed to produce BTS {BTS (total score) = BB (body score, 5 points) + BP (posterior score, 2 points)}. The diagnostic performance of the scoring system for identifying unstable then thoracolumbar burst fractures were assessed. Results: Of the 52 thoracolumbar burst fractures, 34 (65.4%) were unstable and 31 (59.6%) had a Thoracolumbar Injury Classification and Severity score \u2265 5. The diagnostic performance of using BTS \u2265 4 to identify unstable thoracolumbar burst fractures and those with a Thoracolumbar Injury Classification and Severity score \u2265 5 was as follows: sensitivity, 61.8% and 58.1%; specificity, 94.4% and 81.0%; positive predictive value, 95.5% and 81.8%; and negative predictive value, 56.7% and 56.7%, respectively. Conclusions: The proposed bone scan scoring system has a high specificity and positive predictive value for identifying thoracolumbar burst fractures that are unstable or have a Thoracolumbar Injury Classification and Severity score \u2265 5. This scoring system may help to inform decisions regarding surgical management.<\/jats:p>","DOI":"10.3390\/medicina58080979","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T01:42:13Z","timestamp":1658713333000},"page":"979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Instability in Thoracolumbar Burst Fractures Using a New Bone Scan Scoring System"],"prefix":"10.3390","volume":"58","author":[{"given":"Hyung Jin","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Ulsan University Hospital, Ulsan 44033, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seol Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Ik","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Dongkang Medical Center, Ulsan 44033, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-2155","authenticated-orcid":false,"given":"Minjung","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"704","DOI":"10.14245\/ns.2142418.209","article-title":"Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations","volume":"18","author":"Zileli","year":"2021","journal-title":"Neurospine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"422","DOI":"10.3928\/01477447-20100429-24","article-title":"Thoracolumbar burst fractures: A systematic review of management","volume":"33","author":"Alpantaki","year":"2010","journal-title":"Orthopedics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1097\/00007632-198311000-00003","article-title":"The three column spine and its significance in the classification of acute thoracolumbar spinal injuries","volume":"8","author":"Denis","year":"1983","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1097\/01.brs.0000182986.43345.cb","article-title":"A new classification of thoracolumbar injuries: The importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status","volume":"30","author":"Vaccaro","year":"2005","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3171\/2008.12.SPINE08388","article-title":"Thoracolumbar spine trauma classification: The Thoracolumbar Injury Classification and Severity Score system and case examples","volume":"10","author":"Patel","year":"2009","journal-title":"J. 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Spine Surg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/979\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:55:06Z","timestamp":1760140506000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":16,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58080979"],"URL":"https:\/\/doi.org\/10.3390\/medicina58080979","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2022,7,22]]}}}