title: Assessment of stability of the cervical spine in blunt trauma patients: review of the literature, with presentation and preliminary results of a modified traction test protocol.
abstract: OBJECTIVE
  To review the reported efficacy of various imaging techniques in assessing stability of the neck in blunt trauma patients, and to present the protocol and preliminary results of a modified traction test protocol.
  
  
  METHODS
  This is a prospective cohort study.
  
  
  METHODS
  A regional trauma unit in Southern Ontario.
  
  
  METHODS
  People with blunt-trauma injuries who came to the author's consultant practice with "C-spine not cleared" status, from January 2001 through December 2003.
  
  
  METHODS
  A fluoroscopically controlled test of axial traction followed by flexion/extension stressing.
  
  
  METHODS
  Radiographic confirmation of the absence of pathological motion under load.
  
  
  RESULTS
  In 51 cases studied to date, no instabilities have been found. Four cases of minor ligamentous hypermobility have been detected, with stability confirmed and no surgery required. There have been no failures to depict the neck completely, no missed instabilities and no complications of the procedure.
  
  
  CONCLUSIONS
  Cervical stability can be reliably confirmed with this test without any requirement for advanced imaging technology.
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. spinopod@allstream.net
authors.forename: Drew A
authors.initials: DA
authors.lastname: Bednar
authors.forename: Badriya
authors.initials: B
authors.lastname: Toorani
authors.forename: Matthew
authors.initials: M
authors.lastname: Denkers
authors.forename: Hesham
authors.initials: H
authors.lastname: Abdelbary
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005471:Fluoroscopy; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis*; D011446:Prospective Studies; D013124:Spinal Injuries / Q000175:diagnosis* / Q000209:etiology; D014143:Traction; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis*