Computed tomographic scanning reduces cost and time of complete spine evaluation.
BACKGROUND
We hypothesize that data collected from computed tomographic (CT) scans obtained for workup of chest or abdominal injuries provide data that are sufficient to screen for spinal fractures and will decrease the cost and time of spine evaluation after trauma.


METHODS
We reviewed plain radiographs from 55 selected trauma patients who also underwent CT scanning of the chest, abdomen, and pelvis. We also timed the radiologic workup of 50 consecutive trauma patients to determine the time required to complete radiographic spine evaluation.


RESULTS
Forty-seven patients had thoracolumbar fractures. Thirteen patients were found to have 33 thoracolumbar spine fractures identified by CT scan but not plain radiography. Fractures were found on initial trauma CT scans of the chest, abdomen, and pelvis obtained to evaluate for visceral injuries. No injuries seen on plain film were missed on CT scan.


CONCLUSIONS
We recommend using the data acquired from CT scans to evaluate the spine, supplementing them with additional studies only when needed for further clarification.
Brandt
Mary-Margaret
MM
Divisions of Trauma, Burn and Emergency Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA. mmbrandt@med.umich.edu
Wahl
Wendy L
WL
Yeom
Kristen
K
Kazerooni
Ella
E
Wang
Stewart C
SC
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009049:Motorcycles; D018579:Patient Selection; D011446:Prospective Studies; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors; D013996:Time and Motion Studies; D036542:Tomography, Spiral Computed / Q000191:economics / Q000295:instrumentation / Q000592:standards; D014193:Trauma Centers