Keywords:
Emergency, Musculoskeletal spine, CT, Audit and standards, Decision analysis, Acute, Patterns of Care, Trauma
Authors:
D. Luong, C. Maiskell
DOI:
10.26044/ranzcr2022/R-0220
Results
266 consecutive ED patients who underwent CT L-spine were analysed, 63/266 (24%) of the requests were for nonspecific lower back pain and therefore were inappropriate according to the CW recommendations. 59/63 (93.5%) of these patients had no abnormality detected and 4/63 (6.5%) had incidental radiculopathy detected on CT.
179/266 (67%) were appropriately referred in the setting of serious spinal pathology, with 118 out of 179 (66%) found to have no abnormality detected, 60 out of 179 (33.5%) were found to have an acute fracture, and 1 out of 179 (0.5%) was found to have metastatic disease.
20/266 (7.5%) were appropriately referred in the setting of radiculopathy, with 14/20 (70%) found to have radiculopathy and 6/20 (30%) were found to have no abnormality detected. 4/266 (1.5%) were appropriately referred for spinal canal stenosis and 4/4 (100%) were found to have spinal canal stenosis.