![]() Mower WR, Hoffman JR, Pollack CV Jr, Pollack CV Jr, Zucker MI, Browne BJ, Wolfson AB, NEXUS Group (2001) Use of plain radiography to screen for cervical spine injuries. Turetsky DB, Vines FS, Clayman DA, Northup HM (1993) Technique and use of supine oblique views in acute cervical spine trauma. Shaffer MA, Doris PE (1981) Limitation of the cross table lateral view in detecting cervical spine injuries: a retrospective analysis. Silva CT, Doria AS, Traubici J, Moineddin R, Davila J, Shroff M (2010) Do additional views improve the diagnostic performance of cervical spine radiography in pediatric trauma? Am J Roentgenol 194:500–508. įreemyer B, Knopp R, Piche J, Wales L, Williams J (1989) Comparison of five-view and three-view cervical spine series in the evaluation of patients with cervical trauma. įell M (2011) Cervical spine trauma radiographs: swimmers and supine obliques an exploration of current practice. Gan G, Harkey P, Hemingway J, Hughes DR, Duszak R Jr (2016) Changing utilization patterns of cervical spine imaging in the emergency department: perspectives from two decades of national Medicare claims. J Trauma 27:980–986ĭaffner RH, Hackney DB (2007) ACR Appropriateness Criteria® on suspected spine trauma. Reid DC, Henderson R, Saboe L, Miller JD (1987) Etiology and clinical course of missed spine fractures. ![]() Riggins RS, Kraus JF (1977) The risk of neurologic damage with fractures of the vertebrae. Stiell IG, Clement CM, McKnight RD et al (2003) The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. Considering the potential for devastating neurological outcomes from missed cervical fractures, addition of AP, odontoid, and oblique projections continues to detect fractures at a low rate. Performing additional radiographs of the cervical spine including AP, odontoid, and bilateral oblique projections in trauma patients with low pretest probability of fracture augments the diagnostic yield of lateral radiographs. For two of the patients with fractures identified on the lateral projection, an additional fracture was seen when CT was then performed. The yield of the additional projections is one fracture per 9713 radiographic projections (90% confidence interval of one fracture per 1245–47,946 examinations). Three of these fractures were identified on the lateral radiograph, and three of these fractures were visualized on the additional projections (two on oblique and one on odontoid views). Six fractures were detected in 7218 exams. Exam reports and, when necessary, images were reviewed to determine which patients had fractures and on which projection the fractures were identified. For the clinical workflow employed at the time of study acquisition, radiologists prospectively reviewed the lateral projection and subsequently reviewed the entirety of the images obtained. MethodsĪll imaging reports from cervical spine radiography studies on patients aged 18 years and older in the emergency room of a major academic medical center between November 22, 2003, and January 17, 2012, were retrospectively reviewed. We evaluated the diagnostic yield of performing anteroposterior (AP), odontoid, and oblique views in addition to the lateral view in the current era when radiographs are performed only on low-risk patients. ![]() ![]() Plain radiography of the cervical spine is used as a screening test for trauma patients.
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