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- Title
MRI as an Adjunct to Cervical Spine Clearance: A Utility Analysis.
- Authors
Soult, Michael C.; Weireter, Leonard J.; Britt, Rebecca C.; Collins, Jay N.; Novosel, Timothy J.; Reed, Scott F.; Britt, L. D.
- Abstract
Cervical spine (CS) injury occurs in 1 to 3 per cent of blunt trauma patients. The goal of this study is to evaluate the use of magnetic resonance imaging (MRI) as an adjunct to CS computed tomography (CT) in the presence of persistent pain with a normal physical examination or obtundation. A retrospective chart review was performed on 389 blunt trauma patients undergoing both CS CTand MRI between 2007 and 2010. Abnormal CT findings were found in 199. The remaining 190 patients with normal CTscans underwent MRI for persistent pain (109), neurologic symptoms (57), or obtundation (24). Motor vehicle crashes predominated (50%) followed by falls (19%) and motorcycle crashes (12%). In the patients with persistent pain, CT showed no acute injury (89%) with subsequent MRI demonstrating ligamentous edema or injury not seen on CTin 12 per cent of patients. No patient required an operation for CS instability. All the obtunded patients demonstrated localizing motion of four extremities. MRI of these patients demonstrated ligamentous edema or injury not seen on CT in 20 per cent of patients. No obtunded patient had CS instability or needed operative intervention. A localizing physical examination in conjunction with normal CS CTsafely precludes a CS injury requiring cervical fixation. MRI does not add substantially to this decision-making and the cervical collar can be safely removed.
- Subjects
MAGNETIC resonance imaging; CERVICAL vertebrae; TOMOGRAPHY; MEDICAL imaging systems; DECISION making
- Publication
American Surgeon, 2012, Vol 78, Issue 7, p741
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/000313481207800710