Emergency radiology : straightening of the cervical spine in MDCT after trauma--a sign of injury or normal variant?
OBJECTIVE: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding.
METHODS: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients. Two independent readers evaluated retrospectively the alignment, determined the absolute rotational angle of the posterior surface of C2 and C7 (ARA C2-7) and grouped the results for lordosis (<-13°), straight (-13 to +6°) and kyphosis (>+6°).
RESULTS: In the two CCI-/CCI+ study groups, the straight or kyphotic alignment significantly (p = 0.001) predominated over lordosis. The number of patients with straight C-spine alignment was higher in the CCI+ group (CCI+ 69% vs CCI- 49%, p = 0.05). A comparison of the CCI+ group vs the CCI- group revealed a slightly smaller number of kyphotic (10% vs 18%, p = 0.34) and lordotic (21% vs 33%, p = 0.33) alignments. Statistically, however, the differences were of no significance. The control group revealed no significant differences.
CONCLUSION: Straightening of the C-spine alone is not a definitive sign of injury but is a biomechanical variation due to CCI and neck positioning during MDCT or active patient control.
ADVANCES IN KNOWLEDGE: Straightening of the C-spine alignment in MDCT alone is not a definitive sign of injury. Straightening of the C-spine alignment is related to neck positioning and active patient control. CCI has a straightening effect on the cervical alignment.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2016 |
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Erschienen: |
2016 |
Enthalten in: |
Zur Gesamtaufnahme - volume:89 |
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Enthalten in: |
The British journal of radiology - 89(2016), 1061 vom: 15., Seite 20150996 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Linsenmaier, Ulrich [VerfasserIn] |
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Anmerkungen: |
Date Completed 12.09.2016 Date Revised 13.11.2018 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1259/bjr.20150996 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM256429189 |
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500 | |a Citation Status MEDLINE | ||
520 | |a OBJECTIVE: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding | ||
520 | |a METHODS: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients. Two independent readers evaluated retrospectively the alignment, determined the absolute rotational angle of the posterior surface of C2 and C7 (ARA C2-7) and grouped the results for lordosis (<-13°), straight (-13 to +6°) and kyphosis (>+6°) | ||
520 | |a RESULTS: In the two CCI-/CCI+ study groups, the straight or kyphotic alignment significantly (p = 0.001) predominated over lordosis. The number of patients with straight C-spine alignment was higher in the CCI+ group (CCI+ 69% vs CCI- 49%, p = 0.05). A comparison of the CCI+ group vs the CCI- group revealed a slightly smaller number of kyphotic (10% vs 18%, p = 0.34) and lordotic (21% vs 33%, p = 0.33) alignments. Statistically, however, the differences were of no significance. The control group revealed no significant differences | ||
520 | |a CONCLUSION: Straightening of the C-spine alone is not a definitive sign of injury but is a biomechanical variation due to CCI and neck positioning during MDCT or active patient control | ||
520 | |a ADVANCES IN KNOWLEDGE: Straightening of the C-spine alignment in MDCT alone is not a definitive sign of injury. Straightening of the C-spine alignment is related to neck positioning and active patient control. CCI has a straightening effect on the cervical alignment | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a Deak, Zsuszsanna |e verfasserin |4 aut | |
700 | 1 | |a Krtakovska, Aina |e verfasserin |4 aut | |
700 | 1 | |a Ruschi, Francesco |e verfasserin |4 aut | |
700 | 1 | |a Kammer, Nora |e verfasserin |4 aut | |
700 | 1 | |a Wirth, Stefan |e verfasserin |4 aut | |
700 | 1 | |a Reiser, Maximilian |e verfasserin |4 aut | |
700 | 1 | |a Geyer, Lucas |e verfasserin |4 aut | |
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