title: A comparison of flexion and extension radiographs with computed tomography of the cervical spine in blunt trauma.
abstract: The purpose of this study was to compare flexion and extension (F/E) cervical radiographs with CT of the cervical spine in patients sustaining blunt trauma for the evaluation of ligamentous injury. A retrospective chart review of 2 years duration at an American College of Surgeons-verified Level I trauma center was performed. All patients sustaining blunt trauma who were evaluated with both a CT as well as F/E radiographs were identified. Exclusion criteria included penetrating injuries, neurologic symptoms, and age younger than 18 years. Follow-up MRI of each positive F/E radiograph after a negative CT scan was performed. Flexion and extension cervical radiographs were obtained in 379 patients after CT. Eight positive F/E radiographs were obtained after a negative CT scan. Follow-up MRI was negative for ligamentous injury in all cases. No cases of a clinically relevant positive F/E radiograph after a negative CT scan were identified. Follow-up F/E radiographs are not efficacious when a negative CT has been performed in blunt trauma without neurologic findings.
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine-Wichita, Wichita, Kansas, USA.
authors.forename: Travis J
authors.initials: TJ
authors.lastname: Goodnight
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Helmer
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Dort
authors.forename: R Joseph
authors.initials: RJ
authors.lastname: Nold
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Smith
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008022:Ligaments / Q000293:injuries; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000000981:diagnostic imaging*; D011187:Posture; D011237:Predictive Value of Tests; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*