Abstract
to assess the value of computed tomography in the diagnosis of cervical spine and spinal cord injuries in victims of blunt trauma. we reviewed the charts of blunt trauma victims from January 2006 to December 2008. We analyzed the following data: epidemiology, mechanism of trauma, transportation of victims to the hospital, intra-hospital care, indication criteria for CT, diagnosis, treatment and evolution of the victims. The victims were divided into two groups: Group I - without cervical spine injury, Group II - with cervical spine injury. we gathered medical records from 3,101 victims. Computed tomography was performed in 1572 (51%) patients, with male predominance (79%) and mean age of 38.53 years in Group I and 37.60 years in Group II. The distribution of trauma mechanisms was similar in both groups. Lesions found included: 53 fractures, eight vertebral listeses and eight spinal cord injuries. Sequelae included: paraplegia in three cases, quadriplegia in eight and brain injury in five. There were seven deaths in Group II and 240 in Group I. The average length of hospital stay was 11 days for Group I and 26.2 days for Group II. CONCLUSION. A CT scan of the cervical spine in victims of blunt trauma was effective in identifying lesions of the cervical spine and spinal cord injuries. Thus, despite the cost of neck CT and the low incidence of lesions identified by it, its indication based on the usual criteria seems justified.
Highlights
Traumatic injuries account for more than 3.2 million deaths and more than 312 million injured annually worldwide [1,2,3]
The objective of this study is to evaluate the importance of computed tomography (CT) in the diagnosis of cervical spine and spinal cord injuries in blunt trauma victims admitted to a university hospital in a developing country
Imaging (MRI), most traumatic injuries of the spine, which until a few decades ago were often not suspected, are currently identified with certainty . 5,12 Data reported by the National Spinal Cord Injury Association Resource Center 5, using the above criteria for indication of cervical CT, showed that approximately 3% of victims of blunt trauma who undergo CT of the cervical spine has some damage to the spinal cord, such as a fracture or dislocation, and 1% of these victims have spinal cord injury
Summary
Traumatic injuries account for more than 3.2 million deaths and more than 312 million injured annually worldwide [1,2,3]. Traumatic injury of the cervical spinal cord is an extremely worrying problem in trauma patient care throughout the world due to the high risk of death and severe sequelae that result in serious permanent limitations, both physical, social and professional. It causes large health system expenditures, both with prolonged hospitalization and treatment, which usually lasts for years [5,8]. Social and economic costs resulting from cervical spinal cord injuries are enormous, as up to 85% of victims who resist the first 24 hours after trauma survive for more than 10 years 3 and, being in the productive age group, suffer large reduction in productivity due to prolonged absences from work, early retirement and unemployment . 2,5,8-10
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