Emergency cervical spine trauma: Spectrum of injuries and Imaging pictorial review

Congress:

ECR 2020

Poster Number:

C-15006

Type:

Educational Exhibit

Keywords:

Performed at one institution, Not applicable, Trauma, Education, Digital radiography, CT, Emergency, Emergency Imaging

Authors:

L. Garg¹, P. jain², S. B. Grover¹, M. Sinha¹; ¹New Delhi/IN, ²Delhi, Delhi/IN

DOI:

10.26044/ecr2020/C-15006

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-15006

Table 1: NEXUS Criteria

Table 2: Canadian C spine rule

Table 3: High and Low risk Groups

Table 4: ABCs approach to cervical spine imaging evaluation.

Learning objectives

Learning objectives 1. Imaging indication and guidelines for cervical trauma. 2. Role of imaging in diagnosis of various occult and missed cervical spinal injuries. 3. Approach to interpreting and imaging cervical spine trauma. 4. Spectrum of vertebral fractures in cervical spine trauma. 5. Multimodality pictorial review of cervical spine trauma.

Background

A significant percentage of emergency patients present with cervical spinal trauma resulting from road traffic accidents, blunt injuries, and high degree falls. These potentially devastating injuries require accurate and timely intervention to prevent permanent neurological sequelae. Radiographs and multidetector CT are the primary imaging modalities used to evaluate and characterize the exact injury site, spinal stability and associated injuries for guiding prompt management and patient prognostication. The choice of imaging modality is a compromise between the low sensitivity of radiographs for undisplaced fractures and the...

Findings and procedure details

A significant proportion of patients presenting to the emergency department have cervical spinal trauma. This can result from road traffic accidents, blunt injuries and high degree falls and present with a multitude of clinical findings ranging from asymptomatic or minor reversible neurologic injury to severe irreversible deficits and even death. Advanced trauma life support (ATLS) protocol is followed for the management of trauma patients. Airway maintenance and cervical spine protection constitute the first step of this ATLS algorithm. After trauma cervical spine is considered injured...

Conclusion

Prompt and precise injury evaluation through radiographs and CT is fundamental for guiding adequate management in patients with cervical spinal trauma, thereby alleviating the risk of poor prognostic outcomes.

Personal information and conflict of interest

L. Garg; New Delhi/IN - nothing to disclose P. Jain; Delhi, DELHI/IN - nothing to disclose S. B. Grover; NEW DELHI, DELHI/IN - nothing to disclose M. Sinha; New Delhi/IN - nothing to disclose

References

Torretti JA, Sengupta DK. Cervical spine trauma. Indian J Orthop 2007;41:255-6 The Radiology Assistant : Spine - Cervical injury [Internet]. Radiologyassistant.nl. 2020 [cited 20 January 2020]. Available from: https://radiologyassistant.nl/neuroradiology/spine-cervical-injury Dreizin D, Letzing M, Sliker C, Chokshi F, Bodanapally U, Mirvis S et al. Multidetector CT of Blunt Cervical Spine Trauma in Adults. RadioGraphics. 2014;34(7):1842-1865. Tadros A, Tews M. Cervical Spine Imaging in Trauma [Internet]. Saem.org. 2020 [cited 20 January 2020]. Available from: https://www.saem.org/cdem/education/online-education/m3-curriculum/group-traumatic-and-orthopedic-injuries/cervical-spine-imaging-in-trauma