Controversies in cervical spine imaging in trauma patients

The subject of cervical spine imaging for trauma patients has generated significant controversy over the past decade and a half. This review considers three aspects of this controversy. The first examines the indications for cervical imaging, focusing on the factors that determine whether trauma patients are at high or low risk for cervical injury. The second discusses the uses of radiography and computed tomography as the main screening diagnostic examination. In addition to the roles of each modality in this evaluation process, other factors such as efficacy of diagnosis, time requirements for study, and cost will be discussed. The final section explores the methods currently used to "clear" the cervical spine in comatose patients.