Patients who come to the emergency room with cervical spinal injury may have more damage than what is detected. In a study, which is published in the Annals of Emergency Medicine, say that CT imaging may be useful to detect such injuries in patients over and above the normal X-rays.
The study indicates that patients with a cervical spinal injury (CSI) may harbor additional spinal damage not visible on regular x-rays. In fact, more than a third of patients who were thought to have low-risk injuries actually have additional damage that may include significant fractures with the potential to produce serious spinal problems if not detected and treated properly.
This study stands in the face of previous medical thinking in which patients with certain forms of spinal injury were considered at very low risk of having additional injuries. Because of that low risk, physicians were urged to use plain x-rays and avoid computed tomography (CT) in evaluating these cases.
Researchers reviewed patient cases from the National Emergency X-Radiography Utilization Study (NEXUS), which was conducted at 21 centers across the United States.
Study authors found that x-rays failed to detect secondary injuries in 81 of the 224 patients identified with cervical spine injuries - or 36 percent.
The researchers believe that patients with any evidence of cervical spine injury, including those with cervical spine injuries previously considered to be at low risk for secondary injuries, should undergo CT imaging of the entire cervical spine. CT should be obtained both to determine whether secondary injuries are present and to identify those non-contiguous injuries that, in fact, occur in a substantial number of cases.