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Application of imaging guidelines in patients with suspected cervical spine trauma: retrospective analysis and literature review.
MedLine Citation:
PMID:  20809342     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Nima Kokabi; Daniel M S Raper; Minzhi Xing; Bruno Mario Giuffre
Publication Detail:
Type:  Journal Article     Date:  2010-08-31
Journal Detail:
Title:  Emergency radiology     Volume:  18     ISSN:  1438-1435     ISO Abbreviation:  Emerg Radiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431227     Medline TA:  Emerg Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-8     Citation Subset:  IM    
Affiliation:
Northern Clinical School, Royal North Shore Hospital, University of Sydney, Reserve Road, St Leonards, NSW 2065, Australia. nkok4872@uni.sydney.edu.au
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