Routine cervical spine radiography for trauma victims: Does everybody needit?

Objective: The purpose of this study was to evaluate the indication for rou tine cervical spine radiography in trauma patients, Methods: Prospective analysis of radiologic and clinical findings was perfo rmed during a 5-year period. Patients suitable for a clinical decision rule were reviewed separately. Results: of the 1,757 consecutive patients inclu ded in the study, 38 were diagnosed with a cervical spine injury. Of the 59 9 patients suitable for the clinical decision rule, 62 had midline cervical tenderness, including 2 with cervical spine injury. No additional cervical spine injuries were found during follow-up. Conclusion: It is within good practice, and it is also cost-effective, to o btain a cervical spine radiograph only on clinical parameters in trauma pat ients with no apparent bodily trauma and optimal parameters, With this clin ical decision rule, 30.6% of all cervical spine series were redundant, and no (occult) spinal fractures would have been undetected.