Evaluation of Cervical Spine Injuries

Abstract

Critically evaluate the current evidence in evaluation of the cervical spine following trauma. Little has changed in the evaluation of the cervical spine following penetrating trauma. Significant advances have been made in the evaluation following blunt trauma. Recent research has focused on evaluating the accuracy of recent generation-computed tomographic (CT) scanners in excluding (or identifying) significant cervical spine injury. Secondly, recent literature has evaluated the utility of magnetic resonance imaging (MRI) in the evaluation of the cervical spine injury following blunt trauma. Current evidence supports (1) in an adult patient if a high-quality CT scan, interpreted by a trained neuro-radiologist, does not demonstrate any abnormal findings, significant cervical spine injury can be excluded and the collar safely removed; (2) MRI adds little to the evaluation if the CT scan is negative; and (3) MRI scan is helpful if a CT is equivocal or to plan therapy when the CT demonstrates injury.