Document Detail


Clinical Indications for arterial immaging in Cervical trauma.
MedLine Citation:
PMID:  21494192     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study Design: A retrospective cohort study.Objective: To evaluate the clinical indications for acquiring arterial imaging in cervical trauma.Summary of Background Data: Cervical spine injuries are very common in high energy trauma and are frequently seen at level one trauma centers across the country. A clinical standard of care does not exist indicating when further evaluation of the cervical vasculature is warranted after a documented cervical spine injury.Methods: After IRB approval, a retrospective study combining the data from two level one trauma centers was undertaken. An evaluation of every arterial imaging procedure (computerized tomography and magnetic resonance arteriography) of the cervical spine was collected to further delineate indications and outcomes of these imaging modalities.Results: From 2005 to 2009 there were a total of 159 patients who underwent cervical arterial imaging at the two participating institutions for the indication of cervical trauma with concern for arterial injury. Thirty six (22.64%) were found to have an injury following arterial imaging. There was a statistically significant correlation with displaced cervical injuries (p < 0.0153) which were defined as cervical dissociations, perched, and/or jumped facets. The other statistically significant correlation was the presence of a neurological deficit (p < 0.001), defined as any presenting deficit on sensory or motor exam. Level of injury defined as axial (O-C2) versus subaxial (C3-C7), age, BMI, and history of cigarette smoking were not statistically related to vascular injury.Conclusion: Our retrospective evaluation indicates that there should be a lower threshold for obtaining arterial imaging with cervical injury patterns historically known to compromise the vasculature that also have concomitant displaced cervical spine injuries and/or a neurological deficit.
Authors:
Jesse L Even; Kirk A McCullough; Brett A Braly; Justin B Hohl; Yanna Song; Joon Y Lee; Matthew J McGirt; Clinton J Devin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-7
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Vanderbilt University Medical Center, 1215 21st avenue. South, MCe south Tower, Suite 4200, Nashville, TN 37232. 2 University of Pittsburgh Medical Center, Kaufman Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213.
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