[Radiologic diagnosis of cervical spine injuries]

This investigation was designed to evaluate the radiological methods used for diagnosis of cervical spine injuries. In the time from 1977 to 1990, a total of 102 patients with 113 fractures or fracture-dislocations of several segments of the cervical spine were diagnosed and treated in the University Surgical Clinic in Graz; 36 of these patients had lesions of the upper cervical spine and 66, lesions of the lower cervical spine. All trauma patients with disturbances of consciousness or neck discomfort reported on questioning or elicited by palpation underwent three-view radiographic screening for cervical spine injuries (lateral, AP and open-mouth views). This led us to suspect cervical spine injuries in all 102 patients. Computerized tomography was performed in 76 cases, which yielded additional information in 55 cases about the middle and posterior column and the adjacent vertebral bodies. In 13 cases conventional tomograms were important to confirm the diagnosis of dens fracture. Except for the diagnosis of hanged-man and dens fractures, computerized tomography is accepted as the second step for the evaluation of cervical spine injuries. We performed 8 investigations with magnetic resonance imaging in 7 patients, and noted spinal cord lesions of low signal intensity in 3 of these cases.