Cervical spine clearance in adults following blunt trauma: a national survey across major trauma centres in England

Chilvers, G.; Porter, Keith; Choudhary, Surabhi

doi:10.1016/j.crad.2017.11.006

Cited by 10 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whilst the BOAST guidance for spinal clearance in the trauma patient [ 5 ] recommends modern helical CT scanning, it is apparent that there is also use of MRI to clear the spine in the presence of a normal CT scan in the UK [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

A case of missed unstable cervical injury during the COVID-19 pandemic

Archer

Gardner

2020

Journal of Surgical Case Reports

View full text Add to dashboard Cite

This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings and the subsequent management of the injury. The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine.

show abstract

Section: Discussionmentioning

confidence: 99%

A case of missed unstable cervical injury during the COVID-19 pandemic

Archer

Gardner

2020

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

“…If the articulating surfaces overlap less than 50% of their length, the joint is considered to be unstable. A CT scan of the whole cervical spine is becoming more commonly used in the initial assessment of suspected cervical trauma ( Figure 2) [14]. It is available in the majority of trauma centres around the clock and has a high diagnostic value for bony as well as for most of the disco-ligamentous injuries [15,16].…”

Section: Imagingmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Sub-Axial Cervical Facet Dislocation: A Review of Current Concepts

Mubark¹,

Abouelela²,

Hassan³

et al. 2021

Cureus

View full text Add to dashboard Cite

Cervical facet dislocation is a serious injury that carries risks of short- and long-term morbidity. The optimal management of these injuries remains controversial with the ongoing debate regarding indications and requirements for closed reduction, timing, type of surgical approach and method of fixation. This review gives an update on the relevant anatomy, classification systems for sub-axial cervical facet dislocation and an overview of the current concepts regarding their management, including surgical approaches and the choice of implants.

show abstract

“…Finally, clinical concerns persist; the consequences of a missed true cervical injury could be catastrophic for patients; this is of course why controversy rages. Therefore, the practice of not clearing the cervical spine after a normal CT cervical spine remains widespread (29).…”

Section: Limitationsmentioning

confidence: 99%

Cervical Spine Clearance on Trauma Intensive Care: Can We Trust a Negative CT Scan?

Hasandarras

Strandvik

Faramawy

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Cervical spine clearance in intubated victims of blunt trauma remains contentious; accumulating high level evidence suggests that a normal CT cervical spine can be used to clear the c-spine and remove the collar in obtunded emergency department patients to prevent collar-related complications. However, it is unclear whether this holds true for intubated patients in the trauma intensive care unit (TICU).Methods: We performed a retrospective review of 730 intubated trauma patients who presented to the Level 1 Trauma center of a tertiary hospital. We reviewed the rate of missed cervical injuries in patients who had their cervical collars removed based on a normal computed tomography (CT) scan of the cervical spine, as well as rates of collar-related complications.Results: Three hundred and fifty patients had their cervical collars removed in the TICU based on the findings of a high-quality, well-interpreted normal CT cervical spine. Seventy percent of patients were intubated and sedated at the time of collar removal. Fifty-one percent of patients had concomitant traumatic brain injury. The average GCS at time of collar removal was 9. The incidence of missed neurological injury discerned clinically at time of both ICU and hospital discharge was nil (negative predictive value 100%). The rate of collar-related complications was 2%.Conclusion: Based on our findings, it is safe to remove the cervical collar for patients in the TICU following normal CT cervical spine, provided certain quality conditions related to the CT scan are met. Not removing the collar early may be related to increased complications. We provide an algorithm to assist critical-care clinicians in decision-making in this patient cohort

show abstract

Cervical spine clearance in adults following blunt trauma: a national survey across major trauma centres in England

Cited by 10 publications

References 12 publications

A case of missed unstable cervical injury during the COVID-19 pandemic

A case of missed unstable cervical injury during the COVID-19 pandemic

Sub-Axial Cervical Facet Dislocation: A Review of Current Concepts

Cervical Spine Clearance on Trauma Intensive Care: Can We Trust a Negative CT Scan?

Contact Info

Product

Resources

About