Plain x-rays often do not reveal certain types of cervical spine injuries in victims of blunt trauma

2001 ◽  
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
X Rays ◽  
Cervical Spine Injuries ◽  
Spine Injuries

scholarly journals The Management of Unstable Cervical Spine Injuries

2014 ◽  
Vol 5 ◽  
pp. CMTIM.S12263
Author(s):  
Venu M. Nemani ◽  
Han Jo Kim
Keyword(s):  
Cervical Spine ◽  
Medical Condition ◽  
Treatment Plan ◽  
Neurological Status ◽  
Patient Specific ◽  
X Rays ◽  
Mechanism Of Injury ◽  
Imaging Studies ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Injuries to the cervical spine can cause potentially devastating morbidity and even mortality. In this review we discuss the anatomy and biomechanics of the cervical spine. The evaluation and treatment of cervical spine injuries begins with the prompt immobilization of suspected injuries in the field. Once an assessment of the patient's neurological status is made, imaging studies are obtained, which can include X-rays, CT, and MRI. Careful scrutiny of the imaging studies for bony and/or ligamentous injury allows the physician to determine the mechanism of injury, which guides treatment. The ultimate treatment plan can consist of non-operative or operative management, and depends on patient specific factors (medical condition and neurological status), the mechanism of injury, and the resultant degree of instability. With prompt diagnosis and appropriate management, the morbidity of these injuries can be minimized.

Diagnostic imaging of cervical spine injuries following blunt trauma: A review of the literature and practical guideline

Injury ◽  
2009 ◽  
Vol 40 (8) ◽  
pp. 795-800 ◽  
Author(s):  
T.P. Saltzherr ◽  
P.H.P. Fung Kon Jin ◽  
L.F.M. Beenen ◽  
W.P. Vandertop ◽  
J.C. Goslings
Keyword(s):  
Cervical Spine ◽  
Diagnostic Imaging ◽  
Blunt Trauma ◽  
Review Of The Literature ◽  
Cervical Spine Injuries ◽  
Practical Guideline ◽  
Spine Injuries

Cervical Spine Imaging in Blunt Trauma Patients

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Trauma Patients ◽  
Clinical Context ◽  
Cervical Spine Injuries ◽  
Additional Information ◽  
Spine Imaging ◽  
Spine Injuries ◽  
Study Methodology ◽  
Spine Radiographs

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of cervical spine imaging in blunt trauma patients. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study presents a set of five diagnostic criteria that approach 100% sensitivity for identifying clinically important cervical spine injuries and could eliminate one-eighth of all cervical spine radiographs ordered for these patients. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Detection of Cervical Spine Injuries in Alert, Asymptomatic Geriatric Blunt Trauma Patients: Who Benefits from Radiologic Imaging?

2006 ◽  
Vol 72 (9) ◽  
pp. 773-777 ◽  
Author(s):  
Adrian W. Ong ◽  
Aurelio Rodriguez ◽  
Robert Kelly ◽  
Vicente Cortes ◽  
Jack Protetch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Blunt Trauma ◽  
Cervical Spine Injury ◽  
Motor Vehicle ◽  
Spine Injury ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Anatomic Locations

There are differing recommendations in the literature regarding cervical spine imaging in alert, asymptomatic geriatric patients. Previous studies also have not used computed tomography routinely. Given that cervical radiographs may miss up to 60 per cent of fractures, the incidence of cervical spine injuries in this population and its implications for clinical management are unclear. We conducted a retrospective study of blunt trauma patients 65 years and older who were alert, asymptomatic, hemodynamically stable, and had normal neurologic examinations. For inclusion, patients were required to have undergone computed tomography and plain radiographs. The presence and anatomic location of potentially distracting injuries or pain were recorded. Two hundred seventy-four patients were included, with a mean age of 76 ± 10 years. The main mechanisms of injury were falls (51%) and motor vehicle crashes (41%). Nine of 274 (3%) patients had cervical spine injuries. The presence of potentially distracting injuries above the clavicles was associated with cervical injury when compared with patients with distracting injuries in other anatomic locations or no distracting injuries (8/115 vs 1/159, P = 0.03). There was no association of cervical spine injury with age greater or less than 75 years or with mechanism of injury. The overall incidence of cervical spine injury in the alert, asymptomatic geriatric population is low. The risk is increased with a potentially distracting injury above the clavicles. Patients with distracting injuries in other anatomic locations or no distracting injuries may not need routine cervical imaging.

Computed Tomography versus Magnetic Resonance Imaging for Evaluation of the Cervical Spine: How Many Slices do you Need?

2010 ◽  
Vol 76 (4) ◽  
pp. 365-368 ◽  
Author(s):  
Carlos V.R. Brown ◽  
Kelli H. Foulkrod ◽  
Andrew Reifsnyder ◽  
Eric Bui ◽  
Irene Lopez ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Injury Rate ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Missed Injury ◽  
Spine Injuries ◽  
Ct Scanners ◽  
Clinically Significant ◽  
Ct And Mri

Controversy exists regarding the correlation between CT and MRI for evaluation of the cervical spine. We hypothesize that newer-generation CT scanners will improve diagnostic accuracy and may obviate the need for MRI in patients with a normal CT. We compared the missed injury rate of four-slice CT and 64-slice CT performed to evaluate the cervical spine. We conducted a retrospective study from January 2004 to June 2008 of all blunt trauma patients who underwent both a CT and MRI to evaluate the cervical spine. One hundred six blunt trauma patients underwent both CT and MRI, including 43 with four-slice and 63 with 64-slice CT. CT missed three injuries (3%), all of which were clinically significant ligamentous injuries seen only on MRI. The 64-slice CT missed no injuries (0%), whereas the four-slice CT missed all three (7%) of the ligamentous injuries ( P = 0.03). Older-generation CT scanners miss clinically significant injuries in blunt trauma patients and should not be independently relied on to evaluate the cervical spine. The newer 64-slice CT scan does not appear to miss clinically significant cervical spine injuries and may allow clearance of the cervical spine in blunt trauma patients without the addition of an MRI.

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