BACKGROUND: The objective of this study was to compare the utility of plain radiographs to multislice computed tomography (MCT) for cervical spine (c-spine) evaluation. We hypothesized that plain radiographs add no clinically relevant diagnostic information to MCT in the screening evaluation of the c-spine of trauma patients. METHODS: This was a prospective, unblinded, consecutive series of injured patients requiring c-spine evaluation that were imaged with three-view plain films and MCT (occiput to T1 with 3-dimensional reconstruction). The final discharge diagnosis based on all prospectively collected clinical data, MCT, and plain films was utilized as the gold standard for the sensitivity calculation. RESULTS: From October 2004 to February 2005, 667 trauma patients requiring c-spine evaluation were enrolled. Average age was 35.4 years and 70% were male. The mechanism of injury was blunt in 99% and 48.7% occurred as a result of motor vehicle collision. Sixty of 667 (9%) sustained acute c-spine injuries. MCT had a sensitivity of 100% and specificity of 99.5%. Plain films had a sensitivity of 45% and specificity of 97.4%. Plain radiography missed 15 of 27 (55.5%) clinically significant c-spine injuries. CONCLUSION: MCT outperformed plain radiography as a screening modality for the identification of acute c-spine injury in trauma patients. All clinically significant injuries were detected by MCT. Plain films failed to identify 55.5% of clinically significant fractures identified by MCT and added no clinically relevant information.
BACKGROUND: The objective of this study was to compare the utility of plain radiographs to multislice computed tomography (MCT) for cervical spine (c-spine) evaluation. We hypothesized that plain radiographs add no clinically relevant diagnostic information to MCT in the screening evaluation of the c-spine of traumapatients. METHODS: This was a prospective, unblinded, consecutive series of injured patients requiring c-spine evaluation that were imaged with three-view plain films and MCT (occiput to T1 with 3-dimensional reconstruction). The final discharge diagnosis based on all prospectively collected clinical data, MCT, and plain films was utilized as the gold standard for the sensitivity calculation. RESULTS: From October 2004 to February 2005, 667 traumapatients requiring c-spine evaluation were enrolled. Average age was 35.4 years and 70% were male. The mechanism of injury was blunt in 99% and 48.7% occurred as a result of motor vehicle collision. Sixty of 667 (9%) sustained acute c-spine injuries. MCT had a sensitivity of 100% and specificity of 99.5%. Plain films had a sensitivity of 45% and specificity of 97.4%. Plain radiography missed 15 of 27 (55.5%) clinically significant c-spine injuries. CONCLUSION: MCT outperformed plain radiography as a screening modality for the identification of acute c-spine injury in traumapatients. All clinically significant injuries were detected by MCT. Plain films failed to identify 55.5% of clinically significant fractures identified by MCT and added no clinically relevant information.
Authors: Kenji Inaba; Saskya Byerly; Lisa D Bush; Matthew J Martin; David T Martin; Kimberly A Peck; Galinos Barmparas; Matthew J Bradley; Joshua P Hazelton; Raul Coimbra; Asad J Choudhry; Carlos V R Brown; Chad G Ball; Jill R Cherry-Bukowiec; Clay Cothren Burlew; Bellal Joseph; Julie Dunn; Christian T Minshall; Matthew M Carrick; Gina M Berg; Demetrios Demetriades Journal: J Trauma Acute Care Surg Date: 2016-12 Impact factor: 3.313
Authors: James M Elliott; Sudarshan Dayanidhi; Charles Hazle; Mark A Hoggarth; Jacob McPherson; Cheryl L Sparks; Kenneth A Weber Journal: J Orthop Sports Phys Ther Date: 2016-10 Impact factor: 4.751