The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients
| Autor: | Dante D. Yeh, Laura L. Avery, Elie P. Ramly, Ali Y. Mejaddam, Haytham M.A. Kaafarani, David R. King, George C. Velmahos, Marc de Moya |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Orthotic Devices medicine.medical_specialty Lordosis Physical examination Wounds Nonpenetrating Trauma Centers Multidetector Computed Tomography medicine Humans Glasgow Coma Scale Clinical significance Prospective Studies medicine.diagnostic_test business.industry Trauma center Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Massachusetts Spinal Injuries Blunt trauma Cervical Vertebrae Female Surgery Radiology Abnormality business |
| Zdroj: | The American Journal of Surgery. 210:822-826 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2015.04.008 |
| Popis: | Background A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance. Methods All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion–extension views, and/or repeat physical examination. Results Of 3,333 patients (40 ± 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion–extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury. Conclusion Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance. |
| Databáze: | OpenAIRE |
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