Visualization of C7-T1 on portable lateral cervical spine radiographs using a lead-lined acrylic filter.
OBJECTIVE
To determine whether lead-lined acrylic cervical filters can improve the quality of portable lateral cervical spine (c-spine) radiographs for trauma patients.


METHODS
Twenty trauma patients who required portable c-spine x-rays had these taken with a lead filter attached to the collimator of the portable x-ray machine to improve penetration and visualization of lower cervical structures without overpenetrating upper cervical structures. The radiographs of these patients were compared with the first portable c-spine radiographs without filters for 20 controls matched for gender and injury severity. The comparison of radiographs was done by an experienced emergency physician and a neuroradiologist blinded to whether the filter was used.


RESULTS
The two groups were similar for demographic and clinical characteristics. There was a significant improvement in the ability to visualize the C7-T1 level for the filter group compared with the control group (65% vs 30%, p < 0.05). Agreement between the physicians was excellent (kappa = 0.79, 95% CI = 0.60-0.99).


CONCLUSIONS
Lead-lined acrylic filters improve the ability to visualize the lower c-spine in trauma patients.
Division of Emergency Medicine, University of Ottawa, Ontario, Canada.
J V
JV
Quinn
A
A
Cwinn
B
B
Carr
S
S
Grahovac
I
I
Stiell
P
P
Pelland
D000328:Adult; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013679:Technology, Radiologic / Q000295:instrumentation*