Radiography
Volume 16, Issue 1 , Pages 68-77 , February 2010

Imaging suspected cervical spine injury: Plain radiography or computed tomography? Systematic review

  • Gavin Cain

      Affiliations

    • Diagnostic Radiographer, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital, Turner Road, Colchester, CO4 5JL Essex, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 7792974767.
  • ,
  • Jane Shepherdson

      Affiliations

    • Faculty of Health and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 9PT Cambridgeshire, UK
  • ,
  • Vicki Elliott

      Affiliations

    • Faculty of Health and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 9PT Cambridgeshire, UK
  • ,
  • Jon Svensson

      Affiliations

    • Faculty of Health and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 9PT Cambridgeshire, UK
  • ,
  • Patrick Brennan

      Affiliations

    • UCD School of Medicine and Medical Sciences, Health Science Building, Belfield, Dublin 4, Ireland

Received 3 March 2009 ,Revised 12 June 2009 ,Accepted 1 September 2009.

References 

  1. Grossman MD, Reilly PM, Gillett T, Gillet D. National survey of the incidence of cervical spine injury and approaches to cervical spine clearance in U.S. trauma centres. The Journal of Trauma. 1999;47(4):684–690
  2. Mower WR, Hoffman JR, Pollack CV, Zucker MI, Browne BJ, Wolfson AB. Use of plain radiography to screen for cervical spine injuries. Annals of Emergency Medicine. 2001;38(1):1–7
  3. Berlin L. CT versus radiography for the initial evaluation of cervical spine trauma: what is the standard of care?. The American Journal of Roentgenology. 2003;180(4):911–915
  4. Berne JD, Velmahos GC, El Tawil Q, Demetriades D, Asensio JA, Murray JA, et al. Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. The Journal of Trauma. 1999;47(5):896–902
  5. Daffner RH, Sciulli RL, Rodriguez A, Protetch J. Evaluation of suspected cervical spine trauma: A 2-year analysis. Injury. 2006;37(7):652–658
  6. Diaz JJ, Gillman C, Morris JA, May AK, Carrillo YM, Guy J. Are five-view plain films of the cervical spine unreliable? a prospective evaluation in blunt trauma patients with altered mental status. The Journal of Trauma. 2003;55(4):658–664
  7. Griffen MM, Frykberg ER, Kerwin AJ, Schinco MA, Tepas JJ, Rowe K, et al. Radiographic clearance of blunt cervical spine injury: plain radiograph or computed tomography scan?. The Journal of Trauma. 2003;55(2):222–226
  8. Mathen R, Inaba K, Munera F, Teixeira P, Rivas L, McKenney M, et al. Prospective evaluation of multislice computed tomography versus plain radiographic cervical spine clearance in trauma patients. The Journal of Trauma. 2007;62(6):1427–1431
  9. McCulloch PT, France J, Jones DL, Krantz W, Nguyen TP, Chambers C, et al. Helical computed tomography alone compared with plain radiographs with adjunct computed tomography to evaluate the cervical spine after high-energy trauma. The Journal of Bone and Joint Surgery. 2005;87(11):2388–2394
  10. Nguyen GK, Clark R. Adequacy of plain radiography in the diagnosis of cervical spine injuries. Emergency Radiology. 2005;11(3):158–161
  11. Nuñez DB, Zuluaga A, Fuentes-Bernardo DA, Rivas LA, Becerra JL. Cervical spine trauma: how much do we learn by routinely using helical CT?. Radiographics. 1996;16(6):1307–1318
  12. Sharma OP, Oswanski MF, Yazdi JS, Jindal S, Taylor M. Assessment for additional spinal trauma in patients with cervical spine injury. The American Surgeon. 2007;73(1):70–74
  13. Widder S, Doig C, Burrowes P, Larsen G, Hurlbert RJ, Kortbeek JB. Prospective evaluation of computed tomographic scanning for the spinal clearance of obtunded trauma patients: preliminary results. The Journal of Trauma. 2004;56(6):1179–1184
  14. Blackmore CC, Ramsey SD, Mann FA, Deyo RA. Cervical spine screening with CT in trauma patients: a cost-effectiveness analysis. Radiology. 1999;212(1):117–125
  15. Rybicki F, Nawfel RD, Judy PF, Ledbetter S, Dyson RL, Halt PS, et al. Skin and thyroid dosimetry in cervical spine screening: two methods for evaluation and a comparison between a helical CT and radiographic trauma series. The American Journal of Roentgenology. 2002;179(4):933–937
  16. National Institute for Clinical Excellence . Head injury: triage, assessment, investigation and early management of head injury in infants, children and adults. Clinical Guideline 4 (partial update). 2007;
  17. Daffner RH, Hackney DB. American College of Radiology appropriateness criteria on suspected spine trauma. The Journal of the American College of Radiology. 2007;4(11):762–775
  18. Rubin GD, Shiau MC, Schmidt AJ, Fleischmann D, Logan L, Leung AN, et al. Computed tomographic angiography: historical perspective and new state-of-the-art using multi detector-row helical computed tomography. The Journal of Computer Assisted Tomography. 1999;23:1–90
  19. Khan SK, Kunz R, Kleijnen J, Antes G. Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research. Royal Society of Medicine Press Ltd; 2003;
  20. Woodring J, Lee C. The role and limitations of computed tomographic scanning in the evaluation of cervical spine trauma. The Journal of Trauma. 1992;33(5):698–708
  21. Woodring J, Lee C. Limitations of cervical spine radiography in the evaluation of acute cervical trauma. The Journal of Trauma. 1993;34(1):32–39
  22. Bach CM, Steingruber IE, Peer S, Peer-Kuhberger R, Jaschke W, Ogon M. Radiographic evaluation of cervical spine trauma. Plain radiography and conventional tomography versus computed tomography. Archives of Orthopaedic and Trauma Surgery. 2001;121(7):385–387
  23. Schenarts PJ, Diaz J, Kaiser C, Carrillo Y, Eddy V, Morris JA. Prospective comparison of admission computed tomographic scan and plain films of the upper cervical spine in trauma patients with altered mental status. The Journal of Trauma. 2001;51(4):663–669
  24. Brohi K, Healy M, Fotheringham T, Chan O, Aylwin C, Whitley S, et al. Helical computed tomographic scanning for the evaluation of the cervical spine in the unconscious, intubated trauma patient. The Journal of Trauma. 2005;58(5):897–901
  25. Gale SC, Gracias VH, Reilly PM, Schwab CW. The inefficiency of plain radiography to evaluate the cervical spine after blunt trauma. The Journal of Trauma. 2005;59(5):1121–1125
  26. Platzer P, Hauswirth N, Jaindl M, Chatwani S, Vecsei V, Gaebler C. Delayed or missed diagnosis of cervical spine injuries. The Journal of Trauma. 2006;61(1):150–155
  27. Ong AW, Rodriguez A, Kelly R, Cortes V, Protetch J, Daffner RH. Detection of cervical spine injuries in alert, asymptomatic geriatric blunt trauma patients: who benefits from radiologic imaging?. The American Surgeon. 2006;72(9):773–776
  28. Whiting P, Rutjes A, Reitsma J, Bossuyt P, Kleijen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Medical Research Methodology. 2003;3:25–37
  29. Devillé WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, et al. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Medical Research Methodology. 2002;2:9–21
  30. Tatsioni A, Zarin DA, Aronson N, Samson DJ, Flamm CR, Schmid C, et al. Challenges in systematic reviews of diagnostic technologies. Annals of Internal Medicine. 2005;142(12):1048–1055
  31. MacKenzie EJ, Hoyt DB, Sacra JC, Jurkovich GJ, Carlini AR, Teitelbaum SD, et al. National inventory of hospital trauma centres. The Journal of the American Medical Association. 2003;289(12):1515–1522
  32. Bossuyt PM, Reitsma JB, Burns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Annals of internal medicine. 2003;138(1):1–12
  33. Lijmer JG, Mol BW, Heisterkamp S, Bonsel GJ, Prins MH, Meulen JHP, et al. Empirical evidence of design-related bias in studies of diagnostic tests. The Journal of the American Medical Association. 1999;282(11):1061–1066
  34. Bhandari M, Montori VM, Swiontkowski MF, Guyatt GH. User's guide to the surgical literature: how to use an article about a diagnostic test. Journal of Bone and Joint Surgery. 2003;85-A(6):1133–1140
  35. Holmes J, Akkinepalli R. Computed tomography versus plain radiography to screen for cervical spine injury: a meta-analysis. The Journal of Trauma. 2005;58(5):902–905
  36. Tins BJ, Cassar-Pullicino VN. Imaging of acute cervical spine injuries: review and outlook. Clinical Radiology. 2004;59(10):865–880
  37. Richards PJ. Cervical spine clearance: a review. Clinical Radiology. 2004;36(2):248–269
  38. Daffner R. Cervical radiography for trauma patients: a time-effective technique?. The American Journal of Roentgenology. 2001;175(5):1309–1311
  39. Hanson JA, Blackmore CC, Mann FA, Wilson AJ. Cervical spine injury: a clinical decision rule to identify high-risk patients for helical CT screening. The American Journal of Roentgenology. 2000;174(3):713–717
  40. British Trauma Society . Guidelines for the initial management and assessment of spinal injury'. Injury. 2003;34(6):405–425

PII: S1078-8174(09)00069-8

doi: 10.1016/j.radi.2009.09.001

Radiography
Volume 16, Issue 1 , Pages 68-77 , February 2010