Post-traumatic neck pain: a prospective and follow-up study.

Area of Science:

• Emergency Medicine
• Orthopedic Surgery
• Trauma Surgery

Background:

• Post-traumatic neck pain is common in emergency departments.
• Cervical spine injuries require prompt and accurate diagnosis.
• Identifying patients needing imaging is crucial for efficient care.

Purpose of the Study:

• To evaluate the diagnostic accuracy of clinical findings for cervical spine injury in alert trauma patients.
• To assess the outcomes of discharged patients with post-traumatic neck pain.
• To identify factors influencing diagnostic and treatment decisions.

Main Methods:

• Prospective evaluation of 351 alert emergency department patients with post-traumatic neck pain.
• Clinical assessment including history and physical examination (cervical tenderness).
• Follow-up via telephone or letter to assess persistent symptoms and subsequent care.

Main Results:

• Only 2% of patients had confirmed fractures or ligament disruptions.
• Immediate neck pain and posterior midline cervical tenderness showed high sensitivity but variable specificity.
• 43% of discharged patients reported persistent moderate-to-severe neck pain or neurologic symptoms at follow-up.
• 52% of discharged patients without initial radiography later obtained one.
• 66% of discharged patients were involved in litigation.

Conclusions:

• Clinical evaluation alone may help identify alert patients with cervical spine injuries, but requires further validation.
• High rates of persistent symptoms and subsequent radiography suggest a need to reconsider imaging criteria.
• Factors like litigation and symptom duration influence patient management and outcomes.