Radiology Rounds - January 2010 - Imaging Suspected Cervical Spine Trauma

Figure 1. Cervical spine CT demonstrates normal alignment without fracture in a patient who experienced a minor hyperflexion injury. Each year in the United States and Canada, more than 13 million patients are treated for injuries that put them at risk of injury to the cervical spine. Few of these patients have a cervical spine fracture or other serious injury to the neck. It has been common practice to order radiographs for many of these patients even though the vast majority of these studies prove normal. Such use of radiography is inefficient because more than 98% of cervical spine radiographs do not show imaging findings of injury. Although individual radiographs are not costly, the overall cost to the healthcare system is high because of the sheer number of studies ordered. Eliminating unnecessary studies of stable and alert patients would both avoid needless radiation exposure and reduce the unnecessary discomfort of awaiting imaging while laying flat on backboards wearing rigid collars.