| Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature. | |
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MedLine Citation:
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PMID: 15734929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To review the current medical literature on dynamic fluoroscopic and magnetic resonance (MR) imaging assessment of cervical spine stability in obtunded patients who sustained blunt trauma. MATERIALS AND METHODS: The English-language literature within the Swetswise and Medline databases was searched for articles describing dynamic fluoroscopic or MR imaging assessment of cervical spine stability in patients who sustained blunt trauma. Patients with fractures or radiographic signs of injury were excluded. The frequencies of purely ligamentous injuries, injuries requiring immobilization, and other clinically important nonligamentous abnormalities were determined. RESULTS: The frequency of isolated cervical ligamentous injuries diagnosed with dynamic fluoroscopy, as reported in the literature, was 0.9% (11 of 1166 patients), whereas the reported frequency of these injuries diagnosed with MR imaging was 22.7% (125 of 550 patients). All injuries diagnosed with dynamic fluoroscopy and 101 (80.8%) of those diagnosed with MR imaging required continued cervical immobilization. Six (60%) of 10 injuries diagnosed with dynamic fluoroscopy and seven (5.6%) of 125 injuries diagnosed with MR imaging required surgical or halo stabilization. Five (2.5%) of the 200 obtunded patients assessed with MR imaging and six (0.5%) of the 1166 obtunded patients evaluated with dynamic fluoroscopy required surgery. CONCLUSION: Review of the current medical literature provided no clear evidence of the superiority of either MR imaging or dynamic fluoroscopy in the diagnosis of unstable ligamentous injury, although other relative advantages of MR imaging indicate that it is preferred for assessing cervical spine stability in obtunded blunt trauma patients. |
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Authors:
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Clint W Sliker; Stuart E Mirvis; Kathirkamanathan Shanmuganathan |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Radiology Volume: 234 ISSN: 0033-8419 ISO Abbreviation: Radiology Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-28 Completed Date: 2005-04-12 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: United States |
Other Details:
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Languages: eng Pagination: 733-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Diagnostic Imaging, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD 21201, USA. csliker@umm.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cervical Vertebrae
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injuries* Fluoroscopy Humans Longitudinal Ligaments / injuries* Magnetic Resonance Imaging Spinal Injuries / diagnosis* Wounds, Nonpenetrating / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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