Benton R Hunter1, Samuel M Keim2, Rawle A Seupaul1, Gene Hern3. 1. Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 2. Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, Arizona. 3. Department of Emergency Medicine, Alameda County Medical Center - Highland, Oakland, California.
Abstract
BACKGROUND: The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt trauma patients has been recently called into question. CLINICAL QUESTION: In low-risk adult blunt trauma patients, can plain radiographs adequately exclude cervical spine injury when clinical prediction rules cannot? EVIDENCE REVIEW: Four observational studies investigating the performance of plain radiographs in detecting cervical spine injury in low-risk adult blunt trauma patients were reviewed. CONCLUSION: The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.
BACKGROUND: The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt traumapatients has been recently called into question. CLINICAL QUESTION: In low-risk adult blunt traumapatients, can plain radiographs adequately exclude cervical spine injury when clinical prediction rules cannot? EVIDENCE REVIEW: Four observational studies investigating the performance of plain radiographs in detecting cervical spine injury in low-risk adult blunt traumapatients were reviewed. CONCLUSION: The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.
Authors: Malte Lennart Warncke; Nis Jesper Wiese; Enver Tahir; Susanne Sehner; Axel Heinemann; Marc Regier; Klaus Püschel; Gerhard Adam; Julius Matthias Weinrich; Azien Laqmani Journal: PLoS One Date: 2020-10-08 Impact factor: 3.240