title: Imaging the spine for tumour and trauma--a national audit of practice in Irish hospitals.
abstract: OBJECTIVE
  The provision of appropriate spinal imaging in cases of acute injury as a consequence of trauma or tumour is becoming ever more challenging. This study assessed the use of multimodal radiological investigations in the management of spinal cord compression as a result of trauma and metastatic cancer in all major Irish hospitals.
  
  
  METHODS
  We conducted a questionnaire of thirty four hospitals in an effort to assess the provision of these services to patients with possible spinal cord compromise. In all public hospitals the Emergency Department and/or the Orthopaedic Registrars were contacted and asked a series of questions relating to spinal clearance, spinal clearance protocols, CT and MRI scanning facilities and on site orthopaedic services.
  
  
  RESULTS
  All centres participated in the study. 67.64% of centres routinely used a protocol in spinal clearance. In 87% of hospitals the Emergency department were responsible for clearing the spine. 85.3% of hospitals had CT availability during normal working hours (9-5) dropping to 47% availability after hours. MRI was available in 50% of hospitals, with surprisingly just two centres providing out of hours MRI imaging services.
  
  
  CONCLUSIONS
  The provision of radiological services in the management of suspected spinal injuries in Irish hospitals is inadequate in comparison to international best practice. This is most marked in relation to CT and MRI.
authors.affiliation: Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland. johncokelly@gmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Kelly
authors.forename: D E
authors.initials: DE
authors.lastname: O'Briain
authors.forename: G A
authors.initials: GA
authors.lastname: Kelly
authors.forename: J P
authors.initials: JP
authors.lastname: Mc Cabe
mesh_terms: D002985:Clinical Protocols; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008485:Medical Audit; D011446:Prospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology; D013119:Spinal Cord Injuries / Q000175:diagnosis*; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*