Learning objectives
To briefly review the anatomy and physiology of the upper cervical region.
To provide a useful classification of the wide spectrum of fractures and other traumatic lesions that can affect this region.
To review the findings at post-treatment and follow-up imaging,
with emphasis on post-surgical imaging
Background
Cervical trauma is a frequent cause of consultation in emergency departments.
Fractures and ligament lesions are frequent and potentially fatal,
especially in trauma to the upper cervical spine because of its functional and anatomical complexity.
Although neurological lesions are often not initially present,
neurological lesions can develop later after neck trauma.
Cervical CT is widely used to evaluate symptomatic patients and to screen multiple trauma patients.
MDCT has proved its value in both the acute phase and follow-up.
MRI adds information about soft tissues.
Cervical...
Imaging findings OR Procedure details
In acute trauma,
CT is the most useful technique for high risk patients; thus,
CT rather than cervical plain films should be the technique of choice.
CT can also be useful in follow-up.
With the appropriate protocol and post-processing,
MDCT improves the recognition,
characterisation,
and classification of traumatic cervical lesions for determining the appropriate treatment.
Contrast agents can be administered in the same study to rule out damage to cervical arteries.
MRI provides essential additional information in spinal cord and ligament injuries.
For follow-up,
plain...
Conclusion
Cervical trauma involving the C0 to C2 vertebrae is extremely important in terms of frequency and mortality,
so it is essential to detect and characterise it correctly.
CT it is the technique of choice in the acute phase and useful in the follow-up.
MRI can add useful information.
Functional plain films continue to be widely used in the follow up.
References
Sampson MA,
Colquhoun KB,
Hennessy NL.
Computed tomography whole body imaging in multi-trauma: 7 years experience.
Clin Radiol. 2006 Apr;61(4):365-9.
Núñez D Jr.
[The diagnosis of traumatic cervical lesions: a decade of evidence-based change].
Radiologia.2006 Jul-Aug;48(4):185-7.
Stiell IG,
Wells GA,
Vandemheen KL,
Clement CM,
Lesiuk H,
De Maio VJ,
et al.
The Canadian C-spine rule for radiography in alert and stable trauma patients.
JAMA.
2001;286:1841-8.
Hoffman IR.
Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with...
Personal Information
Eva Gómez Roselló
[email protected]
Section of of Neuroradiology
Hospital Josep Trueta.
IDI Girona
Girona,
Spain