The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients

被引：2

作者：

Mejaddam, Ali Y. ^{[1
]}

Kaafarani, Haytham M. A. ^{[1
]}

Ramly, Elie P. ^{[1
]}

Avery, Laura L. ^{[2
]}

Yeh, Dante D. ^{[1
]}

King, David R. ^{[1
]}

de Moya, Marc A. ^{[1
]}

Velmahos, George C. ^{[1
]}

机构：

[1] Massachusetts Gen Hosp, Dept Surg, Div Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Dept Radiol, Div Emergency Radiol, Boston, MA 02114 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2015年 / 210卷 / 05期

关键词：

Cervical spine; Trauma; Loss of lordosis; Computed tomography; OBTUNDED PATIENTS; NECK PAIN; INJURIES; METAANALYSIS; IDENTIFICATION; ASSOCIATION; CLEARANCE;

D O I：

10.1016/j.amjsurg.2015.04.008

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance. METHODS: All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion-extension views, and/or repeat physical examination. RESULTS: Of 3,333 patients (40 +/- 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion-extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury. CONCLUSION: Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：822 / 826

页数：5

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