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Are plain radiographs sufficient to exclude cervical spine injuries in low-risk adults?
Benton R Hunter1, Samuel M Keim2, Rawle A Seupaul1
1Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Background:
The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt trauma patients has been recently called into question.
Clinical Question:
In low-risk adult blunt trauma patients, can plain radiographs adequately exclude cervical spine injury when clinical prediction rules cannot?
Evidence Review:
Four observational studies investigating the performance of plain radiographs in detecting cervical spine injury in low-risk adult blunt trauma patients were reviewed.
Conclusion:
The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.
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