title: Usefulness of full spine computed tomography in cases of high-energy trauma: a prospective study.
abstract: BACKGROUND
  At this hospital, computed tomography (CT) of the full spine is performed on all patients who have sustained high-energy trauma because spinal fractures can be overlooked by referring only to clinical findings and plain X-rays of the spine. The goal of this study is to prospectively detect the occurrence of spinal fractures in cases of high-energy trauma using full spine CT and to evaluate the usefulness of it.
  
  
  METHODS
  Subjects were 179 patients (134 male, 45 female) who were deemed to have sustained high-energy trauma in the 21-month period starting in September 2007. Spinal fractures initially revealed by CT were studied in detail.
  
  
  RESULTS
  Spinal fractures were found in 54 patients (30.2 %); 19 patients had stable fractures, and 41 had unstable fractures. Forty patients had concomitant injuries to organs in addition to spinal injury; these patients had an average Injury Severity Score of 20.2 (4-70). Of 16 patients with a cervical fracture, 6 (37.5 %) had a fracture that did not appear on plain X-rays of the cervical and that was first identified by CT. Of 43 patients with a thoracolumbar fracture, 6 (14.0 %) had a fracture that would have been difficult to detect if a full spine CT had not been done.
  
  
  CONCLUSIONS
  In patients who have sustained high-energy trauma, spinal fractures may be overlooked during primary care by a diagnosis based only on plain X-rays and clinical manifestations. Therefore, patients who have sustained high-energy trauma should be evaluated with full spine CT during primary care.
authors.affiliation: Department of Orthopaedic Surgery, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-0012, Japan, maatomo324@gmail.com.
authors.forename: Masanari
authors.initials: M
authors.lastname: Takami
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nohda
authors.forename: Junya
authors.initials: J
authors.lastname: Sakanaka
authors.forename: Masamichi
authors.initials: M
authors.lastname: Nakamura
authors.forename: Munehito
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013131:Spine / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult