BACKGROUND: Guidelines are in place directing the clearance of the cervical spine in patients who are awake, alert, and oriented, but a gold standard has not been recognized for patients who are obtunded. Our study is designed to determine if magnetic resonance imaging (MRI) detects clinically significant injuries not seen on computed tomographic (CT) scans. METHODS: The trauma registry was used to identify and retrospectively review medical records of blunt trauma patients from January 1, 2005, to March 30, 2012. Only obtunded patients with a CT scan and MRI of the cervical spine were included. RESULTS: The study cohort consisted of 277 patients. In 13 (5%) patients, MRI detected clinically significant cervical spine injuries that were missed by CT scans, and in 7 (3%) these injuries required intervention. The number needed to screen with MRI to prevent 1 missed injury was 21. CONCLUSIONS: The findings suggest that the routine use of MRI in clearing the cervical spine in the obtunded blunt trauma patient.
BACKGROUND: Guidelines are in place directing the clearance of the cervical spine in patients who are awake, alert, and oriented, but a gold standard has not been recognized for patients who are obtunded. Our study is designed to determine if magnetic resonance imaging (MRI) detects clinically significant injuries not seen on computed tomographic (CT) scans. METHODS: The trauma registry was used to identify and retrospectively review medical records of blunt traumapatients from January 1, 2005, to March 30, 2012. Only obtunded patients with a CT scan and MRI of the cervical spine were included. RESULTS: The study cohort consisted of 277 patients. In 13 (5%) patients, MRI detected clinically significant cervical spine injuries that were missed by CT scans, and in 7 (3%) these injuries required intervention. The number needed to screen with MRI to prevent 1 missed injury was 21. CONCLUSIONS: The findings suggest that the routine use of MRI in clearing the cervical spine in the obtunded blunt traumapatient.
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: Mayur B Patel; Stephen S Humble; Daniel C Cullinane; Matthew A Day; Randeep S Jawa; Clinton J Devin; Margaret S Delozier; Lou M Smith; Miya A Smith; Jeannette M Capella; Andrea M Long; Joseph S Cheng; Taylor C Leath; Yngve Falck-Ytter; Elliott R Haut; John J Como Journal: J Trauma Acute Care Surg Date: 2015-02 Impact factor: 3.313
Authors: Bharti Khurana; Abhishek Keraliya; George Velmahos; Adrian A Maung; Christopher M Bono; Mitchel B Harris Journal: Emerg Radiol Date: 2021-12-01
Authors: Mohamed A Mohamed; Karl D Majeske; Gul Sachwani-Daswani; Daniel Coffey; Karim M Elghawy; Amanda Pham; Donald Scholten; Kenneth L Wilson; Leo Mercer; Michael L McCann Journal: Trauma Surg Acute Care Open Date: 2016-10-19