Journal article
Exclusion of cervical spine instability in patients with blunt trauma with normal multidetector CT (MDCT) and radiography
British journal of neurosurgery, v 22(5), pp 669-674
2008
PMID: 19016118
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The objective of the study was to determine if negative multidetector computed tomography (MDCT) and lateral radiography of the cervical spine effectively excludes patients with unstable cervical spine injuries. Over a period of 40 months, 6558 people were admitted to our trauma service with blunt injury and 447 (6.8%) were found to have cervical fractures. Fractures were identified by CT and or lateral radiography. In order to rule out clinically significant instability in the absence of fracture, we identified nine patients who required any type of stabilization of the cervical spine including anterior fusion, posterior fusion and external orthosis. These patients also underwent MR of the cervical spine. Radiography, CT, and MR images and reports of these nine patients were reviewed. Nine patients without a fracture required cervical stabilization. These patients had the following abnormalities: disc herniation with canal stenosis in three, unilateral jumped facet in three, and various other soft tissue abnormalities in three, all of which were evident on CT or radiography. All nine patients had evidence for cervical spine injury or instability by MDCT. Normal MDCT and radiography appears adequate to 'clear' the cervical spine. We recommend that patients requiring cervical spine clearance undergo a complete MDCT and lateral radiograph of the cervical spine. If these studies are entirely normal, then the cervical spine may be cleared. If any abnormalities, including disc herniation, soft tissue swelling and bony malalignments are noted by radiography and or MDCT, further studies, including MR, are indicated prior to clearance of the cervical spine.
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Details
- Title
- Exclusion of cervical spine instability in patients with blunt trauma with normal multidetector CT (MDCT) and radiography
- Creators
- R. F. Sekula - Departments of NeurosurgeryR. H. Daffner - 1Departments of NeurosurgeryM. R. Quigley - Departments of NeurosurgeryA. Rodriguez - Drexel UniversityJ. E. Wilberger - Departments of NeurosurgeryM. Y. Oh - Departments of NeurosurgeryP. J. Jannetta - Departments of NeurosurgeryJack Protetch - Departments of Neurosurgery
- Publication Details
- British journal of neurosurgery, v 22(5), pp 669-674
- Publisher
- Informa UK Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiology (Radiologic Sciences); School of Biomedical Engineering, Science, and Health Systems; SOM Dean - Research Administration
- Web of Science ID
- WOS:000261018400011
- Scopus ID
- 2-s2.0-56549108459
- Other Identifier
- 991019167838004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery