Cervical spine clearance protocols vary considerably

Cervical spine clearance protocols vary considerably

(HealthDay)—Cervical spine clearance protocols for level-1 trauma centers are highly variable, according to a study published in the March 1 issue of Spine.

Alexander A. Theologis, M.D., from the University of California-San Francisco, and colleagues contacted 191 U.S. level-1 trauma centers (response rate, 87 percent) and reviewed all available cervical spine clearance protocols. Four scenarios were evaluated for each protocol: clearing asymptomatic ; imaging for patients who are not amenable to clinical clearance; management strategies for patients with persistent neck pain and negative computed tomographic (CT) scan; and those who are obtunded.

The researchers found that 57 percent of institutions had cervical spine clearance protocols. In 89 percent of protocols, the National Emergency X-Radiography Utilization Study criteria were recommended to clear . CT scans were used as first-line imaging in 60 percent of protocols. Flexion-extension plain radiographs were the most common (30 percent) next step for clearance in patients with persistent neck pain and negative CT scan. A CT scan followed by magnetic resonance imaging was the most common method (31 percent) of clearance in obtunded patients. Dynamic flexion-extension views were recommended for patients who are obtunded in 8 percent of protocols, despite being contraindicated.

"These protocols are highly variable and standardization and utilization of these protocols should be encouraged in all to prevent missed injuries and neurological catastrophes," the authors write.

Relevant financial activities outside the submitted work were disclosed: board membership, expert testimony, consultant, royalties, patents, and stock options.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Chest complaints more costly in obese patients

Mar 08, 2014

(HealthDay)—Higher body mass index (BMI) is associated with increased cost of care and longer hospital stays for patients who present to the emergency department with chest pain and dyspnea, according to ...

Top five low-value actions ID'd in emergency medicine

Feb 19, 2014

(HealthDay)—The top five tests, treatments, and/or disposition decisions that are of little value in emergency medicine have been identified, according to research published online Feb. 17 in JAMA: Internal Me ...

Surgery consultation common after MRI of the spine

Jan 02, 2013

(HealthDay)—Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging (MRI) scan go on to receive a surgical consultation, but few end up ...

Recommended for you

Weight-loss surgery may improve kidney function

Nov 14, 2014

In addition to helping patients shed pounds, weight loss surgery may also improve kidney function, according to a study that will be presented at ASN Kidney Week 2014 November 11-16 at the Pennsylvania Convention Center in ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.