CHAPTER 92 CT VS. X-RAY IN TRAUMATIC CERVICAL SPINE INJURY

Prospective Comparison of Admission Computed Tomographic Scan and Plain Films of the Upper Cervical Spine in Trauma Patients with Altered Mental Status

Schenarts PJ, Diaz J, Kaiser C, et al. J Trauma. 2001;51(4):663–668

BACKGROUND

Cervical spine injuries are common in blunt trauma and may result in neurologic deterioration if diagnosis is delayed. Prior to the advent of widely accessible computed tomography (CT) in the 1990s the standard of care had been cervical radiography (plain films) for the diagnosis of traumatic injury when patients had unreliable examinations secondary to altered mental status (AMS). In 1998, the Eastern Association for the Surgery of Trauma (EAST) released guidelines recommending upper cervical CT (occiput-C3) for evaluation of these patients. Despite this there was very limited data regarding the benefits of this new approach, especially in light of its potential costs, including increased radiation and expense.

OBJECTIVES

To prospectively compare the 1998 EAST guidelines recommending cervical CT to traditional plain films for the evaluation of cervical spine injury in patients with blunt trauma and AMS.

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