Cervical spine - assessment following trauma.

BACKGROUND Although cervical spine trauma is more common following high velocity mechanisms of injury resulting in multiple injuries, falls and low velocity mechanisms may also result in serious cervical spine injury. OBJECTIVE This article describes the assessment and management of potential cervical spine injury in the primary care setting. DISCUSSION Patients presenting following trauma should be assessed for risk of cervical spine injury according to one of two evidence based decision rules. If the nominated decision rule indicates high risk of injury, cervical spine imaging is indicated. An accurate history, physical examination and radiographic screening are required, preferably with computed tomography imaging, or five-view plain X-ray if computed tomography is unavailable. Magnetic resonance imaging should be considered in patients with neurologic symptoms or advanced cervical degenerative disease, as these patients are at particular risk of acute disc and ligamentous injury following trauma.