Spine In Victims Research Articles

Valor diagnóstico da tomografia de coluna cervical em vítimas de trauma contuso

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.

Clearing the Cervical Spine in Victims of Blunt Trauma

Cervical spine injuries occur in 2.3% to 6.4% of victims of blunt trauma. The difficulty of identifying the minority of patients with cervical spine injuries continues to challenge those who triage and treat the acutely injured. We retrospectively reviewed our practice for cervical spine clearance, which consists of three-view plain radiographs supplemented by focused further studies, such as computed or plain film tomography and flexion/extension views, as needed. Fifty-four patients with cervical spine injuries were identified during a 39-month period, which represented approximately 1% of the patients evaluated. Eighty cervical spine injuries were found, of which nine were missed. Review of the six patients in whom the nine cervical spine injuries were missed demonstrated error in the interpretation of radiographic studies in five patients, only two of whom were felt to have technically adequate films in hindsight. We conclude that a protocol based on three-view plain film radiographs supplemented by focused additional studies will allow the visualization of virtually all cervical spine injuries and that the main cause of missed injuries is errors of interpretation.

Clearing the Cervical Spine in Victims of Blunt Trauma

Cervical spine injuries occur in 2.3% to 6.4% of victims of blunt trauma. The difficulty of identifying the minority of patients with cervical spine injuries continues to challenge those who triage and treat the acutely injured. We retrospectively reviewed our practice for cervical spine clearance, which consists of three-view plain radiographs supplemented by focused further studies, such as computed or plain film tomography and flexion/extension views, as needed. Fifty-four patients with cervical spine injuries were identified during a 39-month period, which represented approximately 1% of the patients evaluated. Eighty cervical spine injuries were found, of which nine were missed. Review of the six patients in whom the nine cervical spine injuries were missed demonstrated error in the interpretation of radiographic studies in five patients, only two of whom were felt to have technically adequate films in hindsight. We conclude that a protocol based on three-view plain film radiographs supplemented by focused additional studies will allow the visualization of virtually all cervical spine injuries and that the main cause of missed injuries is errors of interpretation.

Clearing the Cervical Spine in Victims of Blunt Assault to the Head and Neck: What is Necessary?

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.