Justification for decreasing the number of views taken in radiologic follow-up of casper plate cervical spine hardware

Abstract

We tested the null hypothesis that there would be no difference between the diagnostic yield of the lateral radiograph alone and the yield of the lateral and anteroposterior views combined when assessing patients after placement of an anterior cervical appliance. We evaluated 630 radiographic examinations obtained from 117 consecutive patients who had anterior cervical plating. For each examination, we looked at the lateral radiograph first and then at the anteroposterior radiography to determine whether there would be any additional information on the anteroposterior film. Of 501 examinations in which the lateral and anteroposterior views were available, we found that the anteroposterior view added information in 18. In eight of the 18, the added information consisted only of clinically insignificant tilting of the plate. Significant findings were seen in 209 examinations in the lateral view and in 219 examinations with the lateral and anteroposterior views combined. This was not significantly different. The anteroposterior view rarely adds significant information. It probably should be obtained early postoperatively to check for tilting of the plate but after that only for specific indications. This will save money and reduce the patient's exposure to radiation.