'Clearing' cervical spine injuries in polytrauma patients: is it really safe to remove the collar?
Polytrauma patients are at increased risk for occult cervical spine injuries. Those unable to provide clinical clues to injury either remain in hard collars until they are able to cooperate with the physical examination or are deemed "clear of cervical injury" if the emergency room screening radiographs are without obvious bony abnormality. Cervical immobilization for a lengthy period of time is not without morbidity. Missed ligamentous injuries can lead to cervical instability, which in turn can result in permanent neurologic sequelae. This article reviews the current methodologies to "clear the cervical spine" and highlights the inadequacies.
Harris
M B
MB
Department of Orthopedic Surgery, Louisiana State University Medical Center, New Orleans 70112-2254, USA.
Waguespack
A M
AM
Kronlage
S
S
D002574:Cervical Vertebrae / Q000293:injuries*; D005151:Facial Injuries / Q000175:diagnosis; D006801:Humans; D007103:Immobilization; D008279:Magnetic Resonance Imaging; D009104:Multiple Trauma / Q000175:diagnosis*; D009984:Orthopedic Fixation Devices; D013124:Spinal Injuries / Q000175:diagnosis; D014057:Tomography, X-Ray Computed