Cervical spine clearance in the blunt trauma patient: a review of current management strategies.
The risks of overlooking a cervical spine injury in a polytrauma patient still remain substantial even with the development of recent advanced radiologic imaging and practice management guidelines. Cervical spine clearance continues to pose a diagnostic dilemma to the trauma team providing care for these patients. There are several issues with legal, medical, and economic implications: which patient populations require cervical spine radiographs; which views should be obtained; is there efficacy in flexion/extension radiographs, CT scan, or MRI scans; in the obtunded patient can the absence of significant ligamentous injury be demonstrated; who should perform clearance methods and be ultimately responsible for valid clearance. The purpose of this article is to revisit current management strategies for clearance of the cervical spine and explore new findings if any, which have been accepted as standard of care by providers, faced with this challenging responsibility.
Powe
Christopher B
CB
Surgical Intensive Care Unit, Department of Surgery, Section Trauma/Critical Care, and Acute Nurse Practitioner Program, School of Nursing, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA. cpowe@surgery.umsmed.edu
D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000293:injuries*; D006801:Humans; D007103:Immobilization; D008279:Magnetic Resonance Imaging; D009104:Multiple Trauma / Q000175:diagnosis* / Q000209:etiology; D018579:Patient Selection; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D016059:Range of Motion, Articular; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014194:Traumatology / Q000379:methods* / Q000592:standards; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology