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Emerg Radiol. 2011 Jan;18(1):31-8. doi: 10.1007/s10140-010-0901-z. Epub 2010 Aug 31.

Application of imaging guidelines in patients with suspected cervical spine trauma: retrospective analysis and literature review.

Author information

1
Northern Clinical School, Royal North Shore Hospital, University of Sydney, Reserve Road, St Leonards, NSW 2065, Australia. nkok4872@uni.sydney.edu.au

Abstract

Safe and efficient clearance of cervical spine injury in blunt trauma patients has been a controversial topic among health professionals. The increased availability of CT scanners in major trauma centers seems to be a factor that has led to increased number of unnecessary cervical spine imaging using this imaging modality. The objective of this study was to investigate the applicability and efficacy of a pre-test clinical criterion in order to stratify post-blunt trauma victims based on their risk of sustaining cervical spine injury and in turn recommend an appropriate imaging modality accordingly. Goergen's criteria (Australas Radiol 48(3):287, 2004), a pre-investigation diagnostic algorithm was retrospectively applied to 106 blunt trauma victims who presented to a level 1 trauma center in Sydney, Australia, and had a CT scan of cervical spine as part of their initial management. Overall, nine (8.5%) of patients sustained a significant cervical spine injury. All nine patients would be classified as high-risk victims according to the algorithm investigated in this study, warranting CT scanning. No patients with low-risk injuries were demonstrated to have a significant cervical spine injury. There was a statistically significant greater proportion of acute cervical spine injuries detected in the high-risk group (p value = 0.0024). Hence, using Goergen's diagnostic algorithm could reduce the number of unnecessary cervical spine CT scans ordered, while not compromising the quality of care in post-blunt trauma victims.

PMID:
20809342
DOI:
10.1007/s10140-010-0901-z
[Indexed for MEDLINE]

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