Journal article
Cervical spine MRI in patients with negative CT: A prospective, multicenter study of the Research Consortium of New England Centers for Trauma (ReCONECT)
The journal of trauma and acute care surgery, Vol.82(2), pp.263-268
02/01/2017
DOI: 10.1097/TA.0000000000001322
PMID: 27893647
Abstract
BACKGROUND: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. Although some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT.
METHODS: Blunt trauma patients who either were unevaluable or had persistent midline cervicalgia and underwent an MRI of the C-spine after a negative CSCT were enrolled prospectively in eight Level I and II New England trauma centers. Demographics, injury patterns, CT and MRI results, and any changes in cervical spine management as a result of MRI imaging were recorded.
RESULTS: A total of 767 patients had MRI because of cervicalgia (43.0%), inability to evaluate (44.1%), or both (9.4%). MRI was abnormal in 23.6% of all patients, including ligamentous injury (16.6%), soft tissue swelling (4.3%), vertebral disc injury (1.4%), and dural hematomas (1.3%). Rates of abnormal neurological signs or symptoms were not different among patients with normal versus abnormal MRI. (15.2 vs. 18.8%, p = 0.25). The c-collar was removed in 88.1% of patients with normal MRI and 13.3% of patients with an abnormal MRI. No patient required halo placement, but 11 patients underwent cervical spine surgery after the MRI results. Six of the eleven had neurological signs or symptoms.
CONCLUSIONS: In a select population of patients, MRI identified additional injuries in 23.6% of patients despite a normal CSCT. It is uncertain if this is a true limitation of CT technology or represents subtle injuries missed in the interpretation of the scan. The clinical significance of these abnormal MRI findings cannot be determined from this study group. (Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.)
LEVEL OF EVIDENCE: Therapeutic study, level IV.
Details
- Title: Subtitle
- Cervical spine MRI in patients with negative CT: A prospective, multicenter study of the Research Consortium of New England Centers for Trauma (ReCONECT)
- Creators
- Adrian A. Maung - Yale Sch Med, New Haven, CT USADirk C. Johnson - Yale Sch Med, New Haven, CT USAKimberly Barre - Yale Sch Med, New Haven, CT USAThomas Peponis - Massachusetts Gen Hosp, Boston, MA 02114 USATomaz Mesar - Massachusetts Gen Hosp, Boston, MA 02114 USAGeorge C. Velmahos - Massachusetts Gen Hosp, Boston, MA 02114 USADaniel McGrail - Boston Med Ctr, Boston, MA USAGeorge Kasotakis - Boston Med Ctr, Boston, MA USARonald I. Gross - Baystate Med Ctr, Springfield, MA USAMichael S. Rosenblatt - Lahey Hosp & Med Ctr, Burlington, MA USAKristen C. Sihler - Maine Med Ctr, Portland, ME 04102 USARobert J. Winchell - Maine Med Ctr, Portland, ME 04102 USAWalter Cholewczynski - Bridgeport Hosp, Bridgeport, CT USAKathryn L. Butler - Massachusetts Gen Hosp, Boston, MA 02114 USAStephen R. Odom - Beth Israel Deaconess Med Ctr, Boston, MA 02215 USAKimberly A. Davis - Yale Sch Med, New Haven, CT USAReCONECT MRI C-SPINE Study Group
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.82(2), pp.263-268
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0000000000001322
- PMID
- 27893647
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 6
- Language
- English
- Date published
- 02/01/2017
- Academic Unit
- Surgery
- Record Identifier
- 9984746241002771
Metrics
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