Thoracic and lumbar spine radiographs for walking trauma patients--is it necessary?
Numerous patients ambulating independently arrive in the Emergency Department complaining of back pain after being involved in a motor vehicle crash (MVC). We examined the yield of routine screening radiographs of the lumbar and thoracic spine in these patients. A retrospective review was carried out of the records of 3173 patients who were involved in a MVC during a 1-year period and presented to a single medical center. Radiographs of the lumbar spine, thoracic spine, or both were obtained in all patients complaining of back pain. Of 3173 ambulating MVC trauma patients, 35% (1110 patients) complained of thoracic or lumbar back pain. None of the lumbar and thoracic spine radiographs that were obtained in these patients was positive for a fracture or dislocation. The current study suggests that the yield of the routine use of spinal radiographs is very low in patients ambulating independently and complaining of back pain after a MVC.
Tamir
Eran
E
Department of Orthopaedic Rehabilitation, Sheba Medical Center, Tel-Hashomer 52621, Israel.
Anekstein
Yoram
Y
Mirovsky
Yigal
Y
Heim
Michael
M
Dudkiewicz
Israel
I
D000063:Accidents, Traffic; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D016347:Medical Records Systems, Computerized; D011859:Radiography; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D016138:Walking