Routine cervical spine radiography for trauma victims: Does everybody need it?
OBJECTIVE
The purpose of this study was to evaluate the indication for routine cervical spine radiography in trauma patients.


METHODS
Prospective analysis of radiologic and clinical findings was performed during a 5-year period. Patients suitable for a clinical decision rule were reviewed separately.


RESULTS
Of the 1,757 consecutive patients included in the study, 38 were diagnosed with a cervical spine injury. Of the 599 patients suitable for the clinical decision rule, 62 had midline cervical tenderness, including 2 with cervical spine injury. No additional cervical spine injuries were found during follow-up.


CONCLUSIONS
It is within good practice, and it is also cost-effective, to obtain a cervical spine radiograph only on clinical parameters in trauma patients with no apparent bodily trauma and optimal parameters. With this clinical decision rule, 30.6% of all cervical spine series were redundant, and no (occult) spinal fractures would have been undetected.
Department of General Surgery, Rode Kruis Hospital, The Hague, The Netherlands.
M J
MJ
Edwards
S P
SP
Frankema
M C
MC
Kruit
P J
PJ
Bode
P J
PJ
Breslau
A B
AB
van Vugt
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000209:etiology; D020380:Needs Assessment; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014218:Triage / Q000592:standards; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000209:etiology