EFFICACY OF RADIOGRAPHIC EVALUATION OF THE CERVICAL-SPINE IN EMERGENCY SITUATIONS

Evaluation of trauma to the cervical spine usually includes predominan tly normal x-ray studies that prevent expeditious workup and treatment and increase cost. In a retrospective review of the cases of 1,686 co nsecutive trauma patients who had routine radiographs for possible inj ury to the cervical spine, injuries were detected in 32 (1.9%). In a s imilar consecutive group of 597 patients whose cases were more critica lly analyzed prospectively, 17 (2.8%) had suspected injuries; of these , five (0.8%) were true positives. All patients in the prospective gro up with suspected injuries had neck pain, neurologic deficit, or alter ed consciousness, suggesting that emergency radiographic screening acc ording to more selective clinical criteria may be feasible.