An Evidenced-Based Approach to Radiographic Assessment of Cervical Spine Injuries in the Emergency Department

Journal of Emergency Medicine

Volumn 36, Issue 1, 2009, Pages 64-71

  Greenbaum, Jason ^a   Walters, Nathan ^a   Levy, Phillip D ^a  

^a WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

cervical spine injury; computed tomography; plain film radiographs

Indexed keywords

ADULT; ARTICLE; CASE REPORT; CERVICAL SPINE; CERVICAL SPINE INJURY; COMPUTER ASSISTED TOMOGRAPHY; EMERGENCY MEDICINE; EMERGENCY WARD; EVIDENCE BASED MEDICINE; HUMAN; MALE; PRIORITY JOURNAL;

ACCIDENTS, TRAFFIC; ADULT; CERVICAL VERTEBRAE; EMERGENCY SERVICE, HOSPITAL; EVIDENCE-BASED MEDICINE; HUMANS; MALE; PRACTICE GUIDELINES AS TOPIC; SPINAL FRACTURES; TOMOGRAPHY, X-RAY COMPUTED;

EID: 58249096210     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2008.01.014     Document Type: Article

References (62)

1. Crim J.R., Moore K., and Brodke D. Clearance of the cervical spine in multitrauma patients: the role of advanced imaging. Semin Ultrasound CT MR 22 (2001) 283-305
2. Morris C.G., and McCoy E. Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening. Anaesthesia 59 (2004) 464-482
3. Bayless P., and Ray V.G. Incidence of cervical spine injuries in association with blunt head trauma. Am J Emerg Med 7 (1989) 139-142
4. Brohi K., Healy M., Fotheringham T., et al. Helical computed tomographic scanning for the evaluation of the cervical spine in the unconscious, intubated trauma patient. J Trauma 58 (2005) 897-901
5. Bryson B.L., Warren K., Schwedhlem M., Mumford B., and Lenaghan P.A. Trauma to the aging cervical spine. J Emerg Nurs 13 (1987) 334-341
6. Holly L.T., Kelly D.F., Counelis G.J., et al. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg 96 3 Suppl (2002) 285-291
7. Iida H., Tachibana S., Kitahara T., et al. Association of head trauma with cervical spine injury, spinal cord injury, or both. J Trauma 46 (1999) 450-452
8. Michael D.B., Guyot D.R., and Darmody W.R. Coincidence of head and cervical spine injury. J Neurotrauma 6 (1989) 177-189
9. Rockswold G.L. Evaluation and resuscitation in head trauma. Minn Med 64 (1981) 81-84
10. Williams J., Jehle D., Cottington E., and Shufflebarger C. Head, facial, and clavicular trauma as a predictor of cervical-spine injury. Ann Emerg Med 21 (1992) 719-722
11. Spinal Cord Injury Information Network. Facts and figures at a glance 2005. http://www.spinalcord.uab.edu/show.asp?durki=21446 Accessed July 15, 2006
12. Daffner R.H., Sciulli R.L., Rodriguez A., and Protetch J. Imaging for evaluation of suspected cervical spine trauma: a 2-year analysis. Injury 37 (2006) 652-658
13. Trafton P.G. Spinal cord injuries. Surg Clin North Am 62 (1982) 61-72
14. Ghanta M.K., Smith L.M., Polin R.S., Marr A.B., and Spires W.V. An analysis of Eastern Association for the Surgery of Trauma practice guidelines for cervical spine evaluation in a series of patients with multiple imaging techniques. Am Surg 68 (2002) 563-568
15. Cline J.R., Scheidel E., and Bigsby E.F. A comparison of methods of cervical immobilization used in patient extrication and transport. J Trauma 25 (1985) 649-653
16. Grady M.S., Howard M.A., Jane J.A., and Persing J.A. Use of the Philadelphia collar as an alternative to the halo vest in patients with C-2, C-3 fractures. Neurosurgery 18 (1986) 151-156
17. Morris C.G., and McCoy E. Cervical immobilisation collars in ICU: friend or foe?. Anaesthesia 58 (2003) 1051-1053
18. Rosen P.B., McSwain Jr. N.E., Arata M., Stahl S., and Mercer D. Comparison of two new immobilization collars. Ann Emerg Med 21 (1992) 1189-1195
19. Hoffman J.R., Mower W.R., Wolfson A.B., Todd K.H., and Zucker M.I. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med 343 (2000) 94-99
20. Stiell I.G., Wells G.A., Vandemheen K.L., et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA 286 (2001) 1841-1848
21. Stiell I.G., Clement C.M., McKnight R.D., et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med 349 (2003) 2510-2518
22. Woodring J.H., and Lee C. Limitations of cervical radiography in the evaluation of acute cervical trauma. J Trauma 34 (1993) 32-39
23. Davis J.W., Phreaner D.L., Hoyt D.B., and Mackersie R.C. The etiology of missed cervical spine injuries. J Trauma 34 (1993) 342-346
24. Gerrelts B.D., Petersen E.U., Mabry J., and Petersen S.R. Delayed diagnosis of cervical spine injuries. J Trauma 31 (1991) 1622-1626
25. Nunez Jr. D.B., Zuluaga A., Fuentes-Bernardo D.A., Rivas L.A., and Becerra J.L. Cervical spine trauma: how much more do we learn by routinely using helical CT?. Radiographics 16 (1996) 1307-1321
26. Reid D.C., Henderson R., Saboe L., and Miller J.D. Etiology and clinical course of missed spine fractures. J Trauma 27 (1987) 980-986
27. West O.C., Anbari M.M., Pilgram T.K., and Wilson A.J. Acute cervical spine trauma: diagnostic performance of single-view versus three-view radiographic screening. Radiology 204 (1997) 819-823
28. Widder S., Doig C., Burrowes P., et al. Prospective evaluation of computed tomographic scanning for the spinal clearance of obtunded trauma patients: preliminary results. J Trauma 56 (2004) 1179-1184
29. Acheson M.B., Livingston R.R., Richardson M.L., and Stimac G.K. High-resolution CT scanning in the evaluation of cervical spine fractures: comparison with plain film examinations. AJR Am J Roentgenol 148 (1987) 1179-1185
30. Borock E.C., Gabram S.G., Jacobs L.M., and Murphy M.A. A prospective analysis of a two-year experience using computed tomography as an adjunct for cervical spine clearance. J Trauma 31 (1991) 1001-1006
31. Griffen M.M., Frykberg E.R., Kerwin A.J., et al. Radiographic clearance of blunt cervical spine injury: plain radiograph or computed tomography scan?. J Trauma 55 (2003) 222-227
32. Eastern Association for the Surgery of Trauma. Practice management guidelines for identifying cervical spine injuries following trauma. 2000. http://www.east.org/tpg/chap3u.pdf Accessed August 4, 2006
33. American College of Radiology. ACR appropriateness criteria. suspected spine trauma. 2007. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/pdf/ExpertPanelonNeurologicImaging/SpineTraumaUpdateinProgressDoc13.aspx Accessed November 28, 2007
34. Bach C.M., Steingruber I.E., Peer S., et al. Radiographic evaluation of cervical spine trauma. Plain radiography and conventional tomography versus computed tomography. Arch Orthop Trauma Surg 121 (2001) 385-387
35. Barba C.A., Taggert J., Morgan A.S., et al. A new cervical spine clearance protocol using computed tomography. J Trauma 51 (2001) 652-657
36. Berne J.D., Velmahos G.C., El-Tawil Q., et al. Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. J Trauma 47 (1999) 896-903
37. Diaz Jr. J.J., Gillman C., Morris Jr. J.A., et al. Are five-view plain films of the cervical spine unreliable?. A prospective evaluation in blunt trauma patients with altered mental status. J Trauma 55 (2003) 658-664
38. Goergen S.K., Fong C., Dalziel K., and Fennessy G. Development of an evidence-based guideline for imaging in cervical spine trauma. Australas Radiol 47 (2003) 240-246
39. Kirshenbaum K.J., Nadimpalli S.R., Fantus R., and Cavallino R.P. Unsuspected upper cervical spine fractures associated with significant head trauma: role of CT. J Emerg Med 8 (1990) 183-198
40. Link T.M., Schuierer G., Hufendiek A., Horch C., and Peters P.E. Substantial head trauma: value of routine CT examination of the cervicocranium. Radiology 196 (1995) 741-745
41. MacDonald R.L., Schwartz M.L., Mirich D., Sharkey P.W., and Nelson W.R. Diagnosis of cervical spine injury in motor vehicle crash victims: how many X-rays are enough?. J Trauma 30 (1990) 392-397
42. Schenarts P.J., Diaz J., Kaiser C., et al. Prospective comparison of admission computed tomographic scan and plain films of the upper cervical spine in trauma patients with altered mental status. J Trauma 51 (2001) 663-669
43. Holmes J.F., and Akkinepalli R. Computed tomography versus plain radiography to screen for cervical spine injury: a meta-analysis. J Trauma 58 (2005) 902-905
44. Barrett T.W., Mower W.R., Zucker M.I., and Hoffman J.R. Injuries missed by limited computed tomographic imaging of patients with cervical spine injuries. Ann Emerg Med 47 (2006) 129-133
45. Gale S.C., Gracias V.H., Reilly P.M., and Schwab C.W. The inefficiency of plain radiography to evaluate the cervical spine after blunt trauma. J Trauma 59 (2005) 1121-1125
46. Daffner R.H. Cervical radiography for trauma patients: a time-effective technique?. AJR Am J Roentgenol 175 (2000) 1309-1311
47. Hogan G.J., Mirvis S.E., Shanmuganathan K., and Scalea T.M. Exclusion of unstable cervical spine injury in obtunded patients with blunt trauma: is MR imaging needed when multi-detector row CT findings are normal?. Radiology 237 (2005) 106-113
48. Mower W.R., and Hoffman J. Comparison of the Canadian C-spine rule and NEXUS decision instrument in evaluating blunt trauma patients for cervical spine injury. Ann Emerg Med 43 (2004) 515-517
49. Blackmore C.C., Ramsey S.D., Mann F.A., and Deyo R.A. Cervical spine screening with CT in trauma patients: a cost-effectiveness analysis. Radiology 212 (1999) 117-125
50. Hanson J.A., Blackmore C.C., Mann F.A., and Wilson A.J. Cervical spine injury: a clinical decision rule to identify high-risk patients for helical CT screening. AJR Am J Roentgenol 174 (2000) 713-717
51. Grogan E.L., Morris Jr. J.A., Dittus R.S., et al. Cervical spine evaluation in urban trauma centers: lowering institutional costs and complications through helical CT scan. J Am Coll Surg 200 (2005) 160-165
52. Ackland H.M., Cooper D.J., Malham G.M., and Stuckey S.L. Magnetic resonance imaging for clearing the cervical spine in unconscious intensive care trauma patients. J Trauma 60 (2006) 668-673
53. Stassen N.A., Williams V.A., Gestring M.L., Cheng J.D., and Bankey P.E. Magnetic resonance imaging in combination with helical computed tomography provides a safe and efficient method of cervical spine clearance in the obtunded trauma patient. J Trauma 60 (2006) 171-177
54. Sanchez B., Waxman K., Jones T., et al. Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma 59 (2005) 179-183
55. Sliker C.W., Mirvis S.E., and Shanmuganathan K. Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature. Radiology 234 (2005) 733-739
56. Holmes J.F., Mirvis S.E., Panacek E.A., et al. Variability in computed tomography and magnetic resonance imaging in patients with cervical spine injuries. J Trauma 53 (2002) 524-529 discussion 30
57. Freedman I., van Gelderen D., Cooper D.J., et al. Cervical spine assessment in the unconscious trauma patient: a major trauma service's experience with passive flexion-extension radiography. J Trauma 58 (2005) 1183-1188
58. Benzel E.C., Hart B.L., Ball P.A., et al. Magnetic resonance imaging for the evaluation of patients with occult cervical spine injury. J Neurosurg 85 (1996) 824-829
59. Albrecht R.M., Kingsley D., Schermer C.R., et al. Evaluation of cervical spine in intensive care patients following blunt trauma. World J Surg 25 (2001) 1089-1096
60. D'Alise M.D., Benzel E.C., and Hart B.L. Magnetic resonance imaging evaluation of the cervical spine in the comatose or obtunded trauma patient. J Neurosurg 91 1 Suppl (1999) 54-59
61. Katzberg R.W., Benedetti P.F., Drake C.M., et al. Acute cervical spine injuries: prospective MR imaging assessment at a level 1 trauma center. Radiology 213 (1999) 203-212
62. McCulloch P.T., France J., Jones D.L., et al. Helical computed tomography alone compared with plain radiographs with adjunct computed tomography to evaluate the cervical spine after high-energy trauma. J Bone Joint Surg Am 87 (2005) 2388-2394