Is prevertebral soft tissue swelling a useful sign in injury of the cervical spine?

A group of 58 patients with suspected injuries of the cervical spine were reviewed retrospectively. Prevertebral soft tissue swelling occurred in 20 (49 per cent) of 41 patients with definite bone injury. Soft tissue swelling occurred significantly more frequently with injuries to the anterior portion of the cervical spine than to the posterior vertebral elements. No significant correlation was found between soft tissue swelling and level of injury and age of the patient. Out of 17 patients with cervical injuries, 4 (24 per cent) who were subsequently considered not to have sustained bony injury demonstrated apparent soft tissue swelling. The absence of soft tissue swelling should not be considered as evidence for no bony injury. Its presence does not necessarily indicate bony injury.