Helical CT for the Evaluation of Cervical Vertebral Injuries

ABSTRACT

The imaging evaluation of the cervical vertebral column in patients subjected to nontrivial trauma has been a subject of major debate in trauma care. A variety of protocols have been proposed that comprise different combinations of radiographs with or without computed tomography (CT) and magnetic resonance imaging in selected cases. In our institution, helical computed tomography (HCT) of the cervical region has been used in the initial assessment of trauma patients either as a screening modality or as an adjunct to radiography. Our results support the use of HCT because it has improved fracture detection and provided better depiction of the extent of injury. More importantly, we have found that significant fractures can be missed when exclusively relying on radiography. In addition, the time for clearance of the cervical column and the disposition time of patients from the trauma area have been reduced while improving the utilization of CT.

KEYWORDS

Spine trauma - cervical vertebral fractures - helical computed tomography - multi-trauma - initial evaluation