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SPINE

Harris TJ, Blackmore CC, Mirza SK et al.
 Spine 2008;33:1547–53.

The present authors evaluated the necessity of additional imaging investigations in obtunded trauma patients after cervical spine computed tomography (CT) scanning. They found that the false-negative rate of cervical spine CT was very low, and thus that additional investigations were unnecessary, needlessly delaying spinal clearance.

Cervical spine injury is of major concern in the assessment and management of trauma patients. A combination of imaging investigations with clinical assessment is employed in identifying cervical spine injuries and clearing the cervical spine (e.g. removing immobilization collars). The situation is complicated in obtunded patients, with the resultant delay in clinical assessment necessitating prolonged spinal immobilization with its associated risks. Additional investigations beyond initial emergency department imaging are employed to further aid diagnosis. However, information on the value and effectiveness of such investigations in improving injury identification is sparse.

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