Articles: spinal-injuries-diagnostic-imaging.
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Cervical spine injuries are common and essential diagnostic problem. Diagnostic imaging is necessary for proper and effective treatment. Helical computed tomography (CT) and plain radiography are the basic diagnostic methods in cervical spine injuries. ⋯ CT examination is the basic technique of diagnostic imaging in a case of cervical spine injuries. It enables quick, accurate and precise evaluation of bone structures and surrounding soft tissues. CT also enables multiplanar imaging and 3-dimentional imaging.
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Controversy persists regarding the most efficient and effective method of cervical spine evaluation after blunt trauma. Historic guidelines for patients undergoing computed tomography (CT) of the head advocate imaging the occiput-C2 as part of that study. For the remaining cervical spine, plain cervical spine radiographs (CSR) with supplemental CT are recommended. Many patients who require head CT also undergo supplemental cervical spine CT after plain CSR, which leads to separate, discontinuous cervical spine CT scans. We sought to determine the incidence of this in our population. We hypothesized that plain CSR alone often proves inadequate to evaluate the cervical spine in patients who require head CT. ⋯ Plain CSR are inadequate to fully evaluate the cervical spine after blunt trauma, and supplemental CT is commonly required. Complete cervical spine CT is available, efficient, and accurate. Our findings support a growing body of literature that suggests that this modality should be used for blunt trauma patients who require radiographic evaluation of the cervical spine. Plain cervical spine radiographs need not be obtained. The EAST guidelines for cervical spine evaluation after blunt trauma should be updated to reflect this evolving practice pattern.
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A new proposed classification system for thoracolumbar (TL) spine injuries, including injury severity assessment, designed to assist in clinical management. ⋯ Although there will always be limitations to any cataloging system, the TLICS reflects accepted features cited in the literature important in predicting spinal stability, future deformity, and progressive neurologic compromise. This classification system is intended to be easy to apply and to facilitate clinical decision-making as a practical alternative to cumbersome classification systems already in use. The TLICS may improve communication between spine trauma physicians and the education of residents and fellows. Further studies are underway to determine the reliability and validity of this tool.
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Comparative Study
Intervertebral motion after incremental damage to the posterior structures of the cervical spine.
Compare intervertebral motion after incremental damage to posterior cervical structures in whole cadavers to motion in asymptomatic subjects. ⋯ Radiographic assessment of the cervical spine may not be sufficient to exclude even extensive damage to the posterior structures of the cervical spine.