title: Cervical spine clearance when unable to be cleared clinically: a pooled analysis of combined computed tomography and magnetic resonance imaging.
abstract: BACKGROUND
  The role of cervical spine magnetic resonance imaging (MRI) in the evaluation of clinically unevaluable blunt trauma patients has been called into question by several recent studies.
  
  
  METHODS
  A PubMed search was performed for all studies comparing computed tomography and MRI in the assessment of the cervical spine in patients who cannot be evaluated clinically. The radiologic findings and clinical outcomes from each study were collated for analysis.
  
  
  RESULTS
  Data for 1,714 patients were available. All patients had a negative computed tomography scan and then underwent an MRI. There were 271 (15.8%) patients who had a previously undocumented finding on MRI with the majority (98.2%) being a ligamentous injury. Only 5 injuries (1.8%) resulted in surgical intervention.
  
  
  CONCLUSIONS
  MRI identifies additional injuries; however, the vast majority are of minor clinical significance. Routine MRI after a negative computed tomography of the cervical spine is not supported by the current literature.
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA. Electronic address: tplacke78@gmail.com.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Plackett
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Franklin
authors.initials: F
authors.lastname: Wright
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Baldea
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mosier
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Casey
authors.initials: C
authors.lastname: Thomas
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Fred A
authors.initials: FA
authors.lastname: Luchette
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Hieu H
authors.initials: HH
authors.lastname: Ton-That
authors.affiliation: Division of Trauma, Surgical Critical Care, & Burns, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Esposito
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019838:Neck Injuries / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*
keywords: Cervical spine; Computed tomography; Magnetic resonance imaging; Obtunded