Need For Focused Computed Tomographic Scans After Obtaining Cross-Table Lateral Cervical Films
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Background: In blunt trauma patients, a cross-table lateral cervical (CLC) film is often technically inadequate, and focused computed tomographic (CT) scanning of the cervical spine is necessary for reliable evaluation of suspected injuries. The purpose of this study was to calculate the frequency of use of such "supplemental CT scans, " and to evaluate the efficacy of a CLC film as an indicator of the need for supplemental focused CT scanning. Methods: A review of CLC films was performed; hundred initial CLC films, both from cases with injuries and those without injuries were evaluated to determine the lowest vertebra that could be visualized on the film. The frequency of abnormal signs on the CLC films was then examined. Results: Technically adequate CLC films that showed the upper border of the T1 vertebra were not obtained in 70 patients with injuries and 63 patients without injuries. Eighty-eight patients with injuries and 28 patients without injuries had abnormal findings on the CLC films. Overall, 97 patients with injuries and 74 patients without injuries required supplemental CT scanning. In 19 of the 141 vertebral injuries in 100 patients, the vertebral injury could not be identified, regardless of the level, in the CLC films. Conclusion: Supplemental CT scans are frequently required after CLC films are obtained, even in patients without cervical spine injuries. CLC films are also not efficient indicators of the necessity for focused CT scanning. We believe that revised guidelines should be followed routinely for assessment of the cervical spine in obtunded or symptomatic blunt trauma patients.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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