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Risk factors predicting cervical spine fracture on CT in craniocervical trauma - retrospective study
Insights
Identifying cervical spine fractures on CT scans is crucial. Key predictors include specific injury mechanisms and cervical spine pain, aiding early diagnosis in trauma patients.
Area of Science:
- Radiology
- Trauma Surgery
- Emergency Medicine
Background:
- Cervical spine fractures require prompt identification to prevent neurological damage.
- CT scans are standard for diagnosing these injuries, but identifying high-risk patients is essential.
Purpose of the Study:
- To identify risk factors for cervical spine fractures detectable on CT scans.
- To utilize information from patient referral forms for predictive analysis.
Main Methods:
- Retrospective study of adult patients undergoing head and cervical spine CT scans.
- Analysis of potential risk factors including demographics, injury mechanism, symptoms, and co-occurring injuries.
Main Results:
- Cervical or upper thoracic spine fractures occurred in 4.3% of patients.
- Significant predictors included high-risk injury mechanisms (e.g., car accidents, water jumps) and cervical spine pain.
Conclusions:
- Specific injury mechanisms and cervical spine pain are significant predictors of cervical spine fracture on CT.
- Referral form data can aid in identifying patients needing closer CT scan evaluation for cervical spine injury.
Introduction:
The study identifies risk factors predicting cervical spine fracture on CT based on information in the referral form.
Methods:
All patients aged over 18 years with a CT scan of the head and cervical spine completed at the University Hospital Brno in the year 2019 to exclude any fresh trauma were included in the retrospective study. The analyzed potential risk factors included gender, age over 65 years, unconsciousness or impaired consciousness, mechanism of injury, paresthesia or plegia suspected to be associated with trauma, cervical spine pain, other neurological symptomatology, presence of cervical collar, presence of intracranial hemorrhage on head CT, and presence of skull fracture on head CT.
Results:
In total, a cervical or upper thoracic spine fracture was described in 51 of 1177 patients (4.3%). Statistically significant risk factors for cervical spine fracture on CT scan were identified as mechanism of injury similar to car accident or jumping into water (OR 2.52; p=0.004), pain of the cervical spine (OR 1.81; p.
