The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients. Am J Surg 2015 Nov;210(5):822-6
Date
07/07/2015Pubmed ID
26145386DOI
10.1016/j.amjsurg.2015.04.008Scopus ID
2-s2.0-84944354618 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance.
METHODS: All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion-extension views, and/or repeat physical examination.
RESULTS: Of 3,333 patients (40 ± 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion-extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury.
CONCLUSION: Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance.
Author List
Mejaddam AY, Kaafarani HM, Ramly EP, Avery LL, Yeh DD, King DR, de Moya MA, Velmahos GCAuthor
Marc Anthony De Moya MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCervical Vertebrae
Female
Glasgow Coma Scale
Humans
Lordosis
Magnetic Resonance Imaging
Male
Massachusetts
Multidetector Computed Tomography
Orthotic Devices
Prospective Studies
Spinal Injuries
Trauma Centers
Wounds, Nonpenetrating
