title: Role of cervical spine radiography in the initial evaluation of stable high-energy blunt trauma patients.
abstract: BACKGROUND
  Detecting cervical spine injuries in trauma patients is essential because undetected injuries in the this area may result in severe neurological disability and probably quadriplegia. Thus, radiography of the cervical spine is considered mandatory in the initial evaluation of trauma patients according to Advanced Trauma Life Support. This approach results in many unnecessary normal radiographs. Therefore, we performed this study to determine the role of routine cervical radiography in the initial evaluation of stable high-energy blunt trauma patients.
  
  
  METHODS
  This was a prospective cross-sectional study including all hemodynamically stable high-energy blunt trauma patients with negative cervical physical examinations referred to our trauma center during a 5-month period (May to September 2010). Cervical radiographs, computed tomography (CT) scanning and magnetic resonance imaging were performed and reviewed for abnormalities.
  
  
  RESULTS
  During the study period, 1,679 high-energy blunt trauma patients were referred to our center, of which 400 were hemodynamically stable and had negative cervical physical examinations. Cervical radiographs were found to be normal in all patients.
  
  
  CONCLUSIONS
  Cross-table cervical spine radiographs can be limited to those high-energy blunt trauma patients who have a positive cervical physical examination or those in whom the physical examination is not revealing. These radiographs also have low value for detecting occult cervical spine fractures, and CT imaging is considered the modality of choice in these cases.
authors.affiliation: Department of General Surgery, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. fariborz_ghaffarpasand@yahoo.com
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.forename: Mehdi
authors.initials: M
authors.lastname: Foroughi
authors.forename: Ali
authors.initials: A
authors.lastname: Saberi
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Abbasi
authors.forename: Ali Asghar
authors.initials: AA
authors.lastname: Karimi
authors.forename: Babak
authors.initials: B
authors.lastname: Malekpoor
authors.forename: Sam
authors.initials: S
authors.lastname: Zeraatian
authors.forename: Mohammad Vahid
authors.initials: MV
authors.lastname: Hosseini
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
authors.forename: Maryam
authors.initials: M
authors.lastname: Dehghankhalili
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D011859:Radiography; D013124:Spinal Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult