A Comparison of Flexion and Extension Radiographs with Computed Tomography of the Cervical Spine in Blunt Trauma

Author： Goodnight Travis J. Helmer Stephen D. Dort Jonathan M. Nold R. Joseph Smith R. Stephen

Publisher： Southeastern Surgical Congress

ISSN： 0003-1348

Source： The American Surgeon, Vol.74, Iss.9, 2008-09, pp. : 855-857

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Abstract

The purpose of this study was to compare flexion and extension (F/E) cervical radiographs with CT of the cervical spine in patients sustaining blunt trauma for the evaluation of ligamentous injury. A retrospective chart review of 2 years duration at an American College of Surgeons-verified Level I trauma center was performed. All patients sustaining blunt trauma who were evaluated with both a CT as well as F/E radiographs were identified. Exclusion criteria included penetrating injuries, neurologic symptoms, and age younger than 18 years. Follow-up MRI of each positive F/E radiograph after a negative CT scan was performed. Flexion and extension cervical radiographs were obtained in 379 patients after CT. Eight positive F/E radiographs were obtained after a negative CT scan. Follow-up MRI was negative for ligamentous injury in all cases. No cases of a clinically relevant positive F/E radiograph after a negative CT scan were identified. Follow-up F/E radiographs are not efficacious when a negative CT has been performed in blunt trauma without neurologic findings.