Injury to the cervical spine is a serious cause of morbidity and mortality in trauma, particularly in the setting of motor vehicle accidents and falls 1–3. Identification of unstable injury is paramount as early stabilisation can prevent serious neurological sequalae and aid functional recovery 4. Initially described on plain lateral C-spine x-rays, anterior disc-space widening (ADW) may indicate potential injury to the anterior longitudinal ligament (ALL)5 Figure 1. One previous study has demonstrated that CT- ADW is a poor predictor of ALL injury when compared...

The study was performed at a Level 1 tertiary referral trauma centre in Melbourne, Australia with ethics approval (project number 189/20). Patient selection Inclusion All patients who received a CT cervical spine for the indication of traum and a subsequent MRI cervical spine during the same hospital admission over a 5 year period between 1/1/2015 and 31/12/2019. All patients were scanned with cervical spine immobilisation Exclusion: Patients excluded if CT demonstrated a fracture, if MRI was reported as non-diagnostic If initial CT was performed at...

1. Demographics and mechanism of injury Over the 5 year period, 1035 patients fulfilled the study critery and were included in the analysis Patient population had an average age of 45.5 years, the majority of whom were males (58.9%) Predominant mechanism of injury was motor vehicle accident (30.5%) Summary of demographic data (Figure 2) Summary of mechanism of injury (Figure 3) 2.Subjective anterior disc space widening is a poor predictor of ALL injury The ALL was most commonly injured at the level of C5-C6 (Figure...

This study is the first to assess subjective CT-ADW in trauma patients who had no fracture identified on CT and in whom all patients were scanned with cervical spine immobilisation. In the absence of a fracture identified on CT, subjective CT anterior disc space widening is a poor predictor of injury to the anterior longitudinal ligament Overzealous reporting of these signs in isolation may lead to unnecessary investigations with MRI which entails longer inpatient stays, potential delay in management of other patient injuries and, importantly,...

1. Berne JD, Velmahos GC, El-Tawil Q, et al. Value of Complete Cervical Helical Computed Tomographic Scanning in Identifying Cervical Spine Injury in the Unevaluable Blunt Trauma Patient with Multiple Injuries: A Prospective Study. J Trauma Acute Care Surg. 1999 Nov;47(5):896. 2. Malik SA, Murphy M, Connolly P, O’Byrne J. Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients. Eur Spine J. 2008 Apr 1;17(4):585–91. 3. Hu R, Mustard CA, Burns C. Epidemiology of Incident Spinal Fracture in a Complete Population....