OTA 2005 Posters

Scientific Poster #21 Polytrauma/Injury Prevention

:Usefulness of Routine Cervical CT Examination on Patients with Head Trauma in High Energy Injuries: Many Cervical Fractures May Have Been Missed on Plain Films in the Past

Kosuke Tajima, MD; Takashi Sasaki; Katsuki Kono;

Kazuyoshi Yamanaka; So Nomoto (n-all authors);

Department of Orthopaedic Surgery, Saiseikai Kanagawaken Hospital,

Kosuke Tajima; Department of Orthopaedic Surgery,

Saiseikai Kanagawaken Hospital, Kanagawaku Yokohama, Japan

Purpose: In February 2004, our institute began to perform routine cervical CT scans in addition to head CT examinations on patients with blunt head trauma who had received high-energy injuries. The findings of 83 patients who underwent a routine cervical CT within the last 1 year are presented here, and the usefulness of routine cervical CT examinations is discussed. The present report is, to our knowledge, the only prospective study to examine the utility of routine cervical CT examinations.

Methods: Among the patients admitted to the emergency room of our institute after receiving high-energy injuries, 83 patients had blunt head trauma and underwent a routine cervical CT examination in addition to the head CT examination specified by our original protocol for cervical clearance. The mechanism of injury and the presence of cervical bone lesions were noted in each case.

Results: 56 males and 27 females ranging in age from 13 to 77 years (average, 39.5 years) were included in the study. Among these 83 cases, cervical fractures or subluxation were visible in 3 cases on plain films. Although no fractures were seen on the plain films taken in the remaining 80 cases, the additional cervical CT examinations demonstrated 13 cervical fractures in 12 (15%) of these cases.

Discussion/Significance: For patients with blunt head trauma, a cervical CT examination is not usually performed if no evidence of a cervical fracture is found on plain films and no neurologic deficits are present. Nevertheless, the present findings suggest that many cervical fractures may have been missed on plain films in the past, and the routine inclusion of a cervical CT examination in addition to a head CT examination might be appropriate in the evaluation of patients with blunt head trauma who have been involved in a high-energy injury.