Document Detail

Cervical magnetic resonance imaging abnormalities not predictive of cervical spine instability in traumatically injured patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004.
MedLine Citation:
PMID:  15291018     Owner:  NLM     Status:  MEDLINE    
OBJECT: Identifying instability of the cervical spine can be difficult in traumatically injured patients. The goal of this study was to determine whether cervical abnormalities demonstrated on magnetic resonance (MR) imaging are predictive of spinal instability. METHODS: Data in all patients admitted through the Level I trauma service at the authors' institution who had undergone cervical MR imaging were retrospectively reviewed. The reasons for MR imaging screening were neurological deficit, fracture, neck pain, and indeterminate clinical examination (for example, coma). Abnormal soft-tissue (prevertebral or paraspinal) findings on MR imaging were correlated with those revealed on computerized tomography (CT) scanning and plain and dynamic radiography to determine the presence/absence of cervical instability. Of 6328 patients admitted through the trauma service, 314 underwent MR imaging of the cervical spine. Of 166 patients in whom CT scanning or radiography demonstrated normal findings, 70 had undergone MR imaging that revealed abnormal findings. Of these 70 patients, 23 underwent dynamic imaging, the findings of which were normal. In each case of cervical instability (65 patients) CT, radiographic, and MR imaging studies demonstrated abnormalities. Furthermore, there were 143 patients with abnormal CT or radiographic study findings, in 13 of whom MR imaging revealed normal findings. Six of the latter underwent dynamic testing, which demonstrated normal results. CONCLUSIONS: Magnetic resonance imaging is sensitive to soft-tissue injuries of the cervical spine. When CT scanning and radiography detect no fractures or signs of instability, MR imaging does not help in determining cervical stability and may lead to unnecessary testing when not otherwise indicated.
Eric M Horn; Gregory P Lekovic; Iman Feiz-Erfan; Volker K H Sonntag; Nicholas Theodore
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  1     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-08-04     Completed Date:  2004-08-24     Revised Date:  2006-01-05    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  Unknown    
Other Details:
Languages:  eng     Pagination:  39-42     Citation Subset:  IM    
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
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MeSH Terms
Cervical Vertebrae / injuries*,  pathology*
Joint Instability / pathology
Magnetic Resonance Imaging*
Predictive Value of Tests
Retrospective Studies
Spinal Injuries / pathology*
Unnecessary Procedures
Comment In:
J Neurosurg Spine. 2005 Aug;3(2):169; author reply 169   [PMID:  16370308 ]

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