Screening cervical spine MRI after normal cervical spine CT scans in patients in whom cervical spine injury cannot be excluded by physical examination.
BACKGROUND
Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury.


METHODS
A retrospective review was conducted of trauma patients admitted to a level I trauma center from 2002 to 2006, in whom cervical spine injuries could not be excluded by physical examination. All patients with normal results on cervical spine CT followed by cervical spine MRI were included in the analysis.


RESULTS
One hundred twenty patients underwent MRI to examine their cervical spines. Seven patients had abnormal MRI findings suggestive of acute traumatic injury. No MRI studies led to operative intervention. Screening MRI increased from 1% of comatose patients in 2002 to 18% in 2006.


CONCLUSIONS
The use of MRI in patients with normal results on cervical spine CT does not appear to alter treatment.
Steigelman
Megan
M
Division of Trauma, University of Texas, Health Sciences Center, San Antonio, TX, USA.
Lopez
Peter
P
Dent
Daniel
D
Myers
John
J
Corneille
Michael
M
Stewart
Ronald
R
Cohn
Stephen
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000175:diagnosis* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D055815:Young Adult