Skip to main content
SpringerLink
Log in

Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?

  • Original Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

The purpose of the study was to determine the role of magnetic resonance imaging (MRI) in intubated multitrauma patients with normal computed tomography (CT) in excluding unstable ligamentous injury to the cervical spine. A retrospective evaluation was done on those multitrauma patients admitted to the intensive care unit of a level 1 trauma centre who had normal single-slice helical CT cervical spine and underwent MRI for cervical spine clearance from 1/1/04 to 30/6/05. Fifty-five patients met the inclusion criteria. Ten of these patients had a discoligamentous injury identified on MRI; however, all these patients had injuries limited to only one of the three columns of the cervical spine. Single-slice helical CT with sagittal reformats had a negative predictive value of 82% for discoligamentous injury and 100% for unstable injury. A normal single-slice helical CT with sagittal reformats of the cervical spine in intubated trauma patients excluded unstable injuries at follow-up cervical spine MR imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Berne J, Velmahos G, El-Tawil Q et al (1999) Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the not evaluable blunt trauma with multiple injuries: a prospective study. J Trauma 47:896–902, doi:10.1097/00005373-199911000-00014

    Article  PubMed  CAS  Google Scholar 

  2. Pasquale M (1998) Practice management guidelines for trauma: EAST adhoc committee on guideline development—identifying cervical spine instability after trauma. J Trauma 44:945–946, doi:10.1097/00005373-199806000-00001

    Article  Google Scholar 

  3. Ravichandran G, Silver J (1982) Missed injuries of the spinal cord. BMJ 284:953–956

    PubMed  CAS  Google Scholar 

  4. Cooper DJ, Ackland HM (2005) Clearing the cervical spine in unconscious head injured patients—the evidence. Crit Care Resusc 7:181–184

    PubMed  CAS  Google Scholar 

  5. Sanchez B, Waxman K, Jones T et al (2005) Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma 59:179–183, doi:10.1097/01.TA.0000171449.94650.81

    Article  PubMed  Google Scholar 

  6. Padayachee L, Cooper D, Irons S et al (2006) Cervical spine clearance in unconscious traumatic brain injury patients: dynamic flexion-extension fluoroscopy versus computed tomography with three-dimensional reconstruction. J Trauma 60:341–345, doi:10.1097/01.ta.0000195716.73126.12

    Article  PubMed  Google Scholar 

  7. Hogan G, Mirvis S, Shanmuganathan K et al (2005) Exclusion of unstable cervical spine injury in obtunded patients with blunt trauma: is MR imaging needed when multi-detector row CT findings are normal? Radiology 237:106–113, doi:10.1148/radiol.2371040697

    Article  PubMed  Google Scholar 

  8. Brohi K, Healy M, Fotheringham T et al (2005) Helical computed tomographic scanning for the evaluation of the cervical spine in the unconscious, intubated trauma patient. J Trauma 58:897–901, doi:10.1097/01.TA.0000171984.25699.35

    Article  PubMed  Google Scholar 

  9. Denis F (1984) Spinal instability as defined by the three column spine concept in acute spinal trauma. Clin Orthop Relat Res 189:65–76

    PubMed  Google Scholar 

  10. Ackland HM, Cooper DJ, Malham GM, Kossmann T (2007) Factor predicting cervical collar related decubitus ulceration in major trauma patients. Spine 32:423–428, doi:10.1097/01.brs.0000255096.52871.4e

    Article  PubMed  Google Scholar 

  11. Como JJ, Marsha A, Thompson RN et al (2007) Is magnetic resonance imaging essential in clearing the cervical spine in obtunded patients with blunt trauma. J Trauma 63:544–549, doi:10.1097/TA.0b013e31812e51ae

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

We thank Dr Helen Kavnoudias and Nicola Gollogly for their assistance.

Author information

Authors and Affiliations

  1. Department of Radiology, The Alfred Hospital, P. O. Box 315, Commercial Rd, Prahran, VIC, Australia, 3181

    Mark Schoenwaelder, William Maclaurin & Dinesh Varma

  2. Department of Surgery, Monash University, Clayton, VIC, Australia

    Dinesh Varma

Authors
  1. Mark Schoenwaelder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William Maclaurin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dinesh Varma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Schoenwaelder.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schoenwaelder, M., Maclaurin, W. & Varma, D. Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?. Emerg Radiol 16, 129–132 (2009). https://doi.org/10.1007/s10140-008-0749-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-008-0749-7

Keywords

Search

Navigation