Optimal assessment of cervical spine trauma in critically ill patients: A prospective evaluation

Abstract

There is no uniformly accepted protocol for the radiological assessment of the cervical spine in critically ill trauma patients. The Alfred Trauma Centre receives about 40% of Victorian patients with major trauma. A protocol was developed for cervical spine evaluation, comprising three plain X-rays and a swimmer's view added when necessary to visualize C7-T1, CT and/or MRI for abnormal regions, and functional (flexion/extension) X-rays to exclude cervical spine instability, due to soft tissue trauma. Functional X-rays were performed 'actively' in conscious patients and 'passively' in unconscious patients. One hundred consecutive patients were prospectively evaluated and 91 survived to comple..