Daniel Novick1, Raina Wallace2, Jody C DiGiacomo3, Anand Kumar4, Steven Lev5, L D George Angus6. 1. Department of Radiology, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: dnovick@numc.edu. 2. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: rwallace@numc.edu. 3. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: jdigiac1@numc.edu. 4. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: akumar6@numc.edu. 5. Department of Radiology, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: slev@numc.edu. 6. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: langus@numc.edu.
Abstract
BACKGROUND: The newest CT scanners provide resolution comparable to MRIs leading many to question when and whether cervical spine MRIs are warranted. METHODS: An 8 year retrospective review identified 241 patients who underwent CT scan and MRI of the cervical spine. The initial clinical examination, cervical spine CT scan, and cervical spine MRI were compared to identify cervical spine injuries that would have been missed had the MRI not been performed. RESULTS: The CT scans were normal in 153 patients, and abnormal in 88. Of the 88 abnormal CT scans, the MRIs were abnormal in 65, and normal in the other 23. The indications for MRI in patients with normal CT scans were neck pain, an abnormal neurologic examination, and/or altered mental status. Of the 13 patients with abnormal MRIs, none were pain free with a normal clinical examination. CONCLUSION: In the absence of focal signs of neurologic injury, the cervical spine can be cleared without a clinical exam or MRI if the cervical CT scan does not demonstrate injury or abnormality.
BACKGROUND: The newest CT scanners provide resolution comparable to MRIs leading many to question when and whether cervical spine MRIs are warranted. METHODS: An 8 year retrospective review identified 241 patients who underwent CT scan and MRI of the cervical spine. The initial clinical examination, cervical spine CT scan, and cervical spine MRI were compared to identify cervical spine injuries that would have been missed had the MRI not been performed. RESULTS: The CT scans were normal in 153 patients, and abnormal in 88. Of the 88 abnormal CT scans, the MRIs were abnormal in 65, and normal in the other 23. The indications for MRI in patients with normal CT scans were neck pain, an abnormal neurologic examination, and/or altered mental status. Of the 13 patients with abnormal MRIs, none were pain free with a normal clinical examination. CONCLUSION: In the absence of focal signs of neurologic injury, the cervical spine can be cleared without a clinical exam or MRI if the cervical CT scan does not demonstrate injury or abnormality.