Clinical outcomes of magnetic resonance imaging in blunt cervical trauma.
OBJECTIVE
To determine whether MRI of the cervical spine resulted in a change in management of patients with blunt trauma and normal plain X-ray (XR)/CT of the cervical spine.


METHODS
An explicit chart review was conducted of patients seen at a Level 1 trauma centre over a 1 year period. Clinical details were extracted from the charts of patients with blunt trauma who had a normal plain XR and CT scan of the cervical spine and who underwent cervical spine MRI. A comparison of clinical details was made between those with a normal/abnormal MRI secondary to the acute injury.


RESULTS
One hundred and thirty-four patients met entry criteria. Discharge non-operative management of the cervical spine was associated with a change in management by the MRI result (P < 0.0001) where MRI of the cervical spine occurred a median of 3 days (interquartile range 0-4.5, range 0-137) after the injury. The MRI occurred before discharge 90% of the time in both groups. Operative management occurred in three patients and was delayed until after first outpatient review in two patients.


CONCLUSIONS
An abnormal MRI after normal plain XR and CT cervical spine studies resulted in a change in non-operative management at discharge. Early MRI resulted in one patient receiving surgery before discharge. No unstable injuries were detected by MRI that were not evident on plain XR or CT cervical spine.
Labattaglia
Matthew P
MP
Emergency and Trauma Centre, Alfred Hospital, Melbourne, Australia. mattlabb@gmail.com
Cameron
Peter A
PA
Santamaria
Mark
M
Varma
Dinesh
D
Thomson
Kevin
K
Bailey
Michael
M
Kossmann
Thomas
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000175:diagnosis*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014739:Victoria; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*