Faculty Collaboration Database

Clearing the cervical spine in victims of blunt assault to the head and neck: what is necessary? Am Surg 2000 Apr;66(4):326-30; discussion 330-1

Date

04/25/2000

Pubmed ID

10776867

Scopus ID

2-s2.0-0034040498 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

A number of guidelines have been proposed to aid in determining the need for radiologic evaluation of the cervical spine (c-spine) in victims of blunt trauma. Mechanism of injury has not been shown to be an independent predictor of injury or the lack thereof. The current study was undertaken to determine the incidence of clinically relevant c-spine injuries in patients who sustained a blunt assault to the head and neck. The trauma registry of an urban Level 1 trauma center was used to identify patients who suffered a blunt assault to the head and neck and were admitted to the hospital over a 30-month period. One hundred two patients were identified. Only 8 patients met criteria for clinical clearance of the c-spine. Eighty patients were unable to be evaluated because of head injury or intoxicants; 14 patients had neck pain on initial examination. These 94 patients underwent plain film examination of their c-spine. Twelve required CT scanning to supplement visualization. The possibility of ligamentous injury was investigated by MRI or flexion/extension radiographs in 26 patients. No clinically significant c-spine injuries were identified. Although many victims of a blunt assault to the head and neck region may have a decreased LOC or neck pain, the likelihood of a ligamentous injury is so low that plain-film X-ray evaluation of the c-spine is all that is necessary to rule out injury in this patient population.

Author List

Patton JH, Kralovich KA, Cuschieri J, Gasparri M

Author

Mario G. Gasparri MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cervical Vertebrae
Craniocerebral Trauma
Crime Victims
Female
Fluoroscopy
Humans
Incidence
Magnetic Resonance Imaging
Male
Michigan
Neck Injuries
Spinal Injuries
Wounds, Nonpenetrating