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Acute Spine Trauma in Adults and Children: Evidence-Based Emergency Imaging

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Part of the book series: Evidence-Based Imaging ((Evidence-Based Imag.))

Abstract

Spinal trauma can lead to permanent neurologic damage. In addition to the neurological deficit, spinal cord injury has additional important ramifications. This includes a precipitous decline in probability of employment, educational achievement, and intact marriage. Therefore, although spinal cord injury is relatively uncommon, spine imaging is frequently performed to exclude suspected and occult fractures. As a result of wide spread utilization, the positive yield of spine imaging is estimated to be only 2.4% in the cervical spine when all patient populations are included. Using the best available evidence, this chapter addresses diagnostic imaging of the spine in trauma including clinical prediction rules and cost-effectiveness.

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References

  1. National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. 2011.

    Google Scholar 

  2. Hoffman JR, Mower WR, Wolfson AB, et al. N Engl J Med. 2000;343(2):94–9.

    Article  CAS  PubMed  Google Scholar 

  3. Pickett GE, Campos-Benetez M, Keller JL, et al. Spine. 2006;31:799–805.

    Article  PubMed  Google Scholar 

  4. Hoffman JR, Schriger DL, Mower W, et al. Ann Emerg Med. 1992;21(12):1454–60.

    Article  CAS  PubMed  Google Scholar 

  5. Fredø H, Rizvi SAM, Lied B, et al. Scan J Trauma Resus Emerg Med. 2012;20:1–7.

    Article  Google Scholar 

  6. Sekhon LH, Fehlings MG. Spine. 2001;26:S2–S12.

    Article  CAS  PubMed  Google Scholar 

  7. Milby AH, Halpern CH, Guo W, et al. Neurosurg Focus. 2008;25(5):E10.

    Article  PubMed  Google Scholar 

  8. Goldberg W, Mueller C, Panacek E, et al. Ann Emerg Med. 2001;38(1):17–21.

    Article  CAS  PubMed  Google Scholar 

  9. Lomoschitz F, Blackmore C, Mirza S, et al. AJR. 2002;178:573–7.

    Article  CAS  PubMed  Google Scholar 

  10. Berkowitz M, O’Leary PK, Kruse DL, et al. Spinal cord injury: an analysis of medical and societal costs. New York: Demos Publications; 1998.

    Google Scholar 

  11. Stiell I, Wells G, Vandemheen K, et al. JAMA. 2001;286:1841–8.

    Article  CAS  PubMed  Google Scholar 

  12. Duane TM, Dechert T, Wolfe LG, et al. J Trauma. 2007;62(6):1405–8; discussion 8–10.

    Google Scholar 

  13. Duane TM, Mayglothling J, Wilson SP, et al. J Trauma. 2011;70:829–31.

    Article  PubMed  Google Scholar 

  14. Duane TM, Young A, Mayglothling J, et al. J Trauma Acute Care Surg. 2013;74:1098–101.

    Article  PubMed  Google Scholar 

  15. Stiell IG, Clement CM, Grimshaw J, et al. BMJ. 2009;339:b4146.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Stiell IG, Clement CM, McKnight RD, et al. N Engl J Med. 2003;349(26):2510–8.

    Article  CAS  PubMed  Google Scholar 

  17. Dickinson G, Stiell IG, Schull M, et al. Ann Emerg Med. 2004;43:507–14.

    Article  PubMed  Google Scholar 

  18. Acheson MB, Livingston RR, Richardson ML, et al. AJR. 1987;148(6):1179–85.

    Article  CAS  PubMed  Google Scholar 

  19. Woodring JH, Lee C. J Trauma. 1993;34(1):32–9.

    Article  CAS  PubMed  Google Scholar 

  20. Blackmore CC, Ramsey SD, Mann FA, et al. Radiology. 1999;212(1):117–25.

    Article  CAS  PubMed  Google Scholar 

  21. Griffen MM, Frykberg ER, Kerwin AJ, et al. J Trauma. 2003;55(2):222–6; discussion 6–7.

    Google Scholar 

  22. Hunter BR, Keim SM, Seupaul RA, et al. J Emerg Med. 2014;46:257–63.

    Article  PubMed  Google Scholar 

  23. Bailitz J, Starr F, Beecroft M, et al. J Trauma. 2009;66(6):1605–9.

    Article  PubMed  Google Scholar 

  24. Blackmore CC, Emerson SS, Mann FA, et al. Radiology. 1999;211:759–65.

    Article  CAS  PubMed  Google Scholar 

  25. Blackmore CC, Zelman WN, Glick ND. Radiology. 2001;220:581–7.

    Article  CAS  PubMed  Google Scholar 

  26. Nunez DB, Ahmad AA, Coin CG, et al. Emerg Radiol. 1994;1(6):273–8.

    Article  Google Scholar 

  27. Antevil JL, Sise MJ, Sack DI, et al. J Trauma. 2006;61:382–7.

    Article  PubMed  Google Scholar 

  28. Daffner RH. AJR Am J Roentgenol. 2001;177(3):677–9.

    Article  CAS  PubMed  Google Scholar 

  29. Grogan EL, Morris JA, Dittus RS, et al. J Am Coll Surg. 2005;200:160–5.

    Article  PubMed  Google Scholar 

  30. ACR. ACR Appropriateness Criteria. 2008. Available from: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/pdf/ExpertPanelonMusculoskeletalImaging/SuspectedCervicalSpineTraumaDoc22.aspx

  31. Como JJ, Diaz JJ, Dunham CM, et al. J Trauma. 2009;67:651–9.

    Article  PubMed  Google Scholar 

  32. Gonzalez-Beicos A, Nunez DB Jr. Semin Ultrasound CT MR. 2009;30(3):159–67.

    Article  PubMed  Google Scholar 

  33. Rybicki F, Nawfel RD, Judy PF. AJR. 2002;179:933–7.

    Article  PubMed  Google Scholar 

  34. Brenner DJ, Hall EJ. N Engl J Med. 2007;357:2277–84.

    Article  CAS  PubMed  Google Scholar 

  35. Richards PJ, Summerfield R, George J, et al. Injury. 2008;39:347–56.

    Article  PubMed  Google Scholar 

  36. Inaba K, Kirkpatrick AW, Finkelstein J, et al. Injury. 2001;32(3):201–7.

    Article  CAS  PubMed  Google Scholar 

  37. Hanson JA, Blackmore CC, Mann FA, et al. AJR. 2000;174:713–8.

    Article  CAS  PubMed  Google Scholar 

  38. Hennessy D, Widder S, Zygun D, et al. J Trauma. 2010;68:576–82.

    Article  PubMed  Google Scholar 

  39. Hogan GJ, Mirvis SE, Kathirkamanathan S, et al. Radiology. 2005;237:106–13.

    Article  PubMed  Google Scholar 

  40. Harris TJ, Blackmore CC, Mirza SK, et al. Spine. 2008;33:1547–53.

    Article  PubMed  Google Scholar 

  41. Brohi K, Healy M, Fotheringham T, et al. J Trauma. 2005;58:897–901.

    Article  PubMed  Google Scholar 

  42. Schuster R, Waxman K, Sanchez B, et al. Arch Surg. 2005;140:762–6.

    Article  PubMed  Google Scholar 

  43. Como JJ, Leukhardt WH, Anderson JS, et al. J Trauma. 2011;70:345–51.

    Article  PubMed  Google Scholar 

  44. Patel MB, Humble SS, Culliname DC, et al. J Trauma Acute Care Surg. 2015;78:430–41.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Schoenfeld AJ, Bono CM, McGuire KJ, et al. J Trauma. 2010;68:109–14.

    Article  PubMed  Google Scholar 

  46. Blackmore CC. Acad Radiol. 2004;11:134–40.

    Article  PubMed  Google Scholar 

  47. Morris CGT, McCoy E. Anaesthesia. 2004;59:464–82.

    Article  CAS  PubMed  Google Scholar 

  48. Morris CGT, McCoy E, Lavery GG. BMJ. 2004;329:495–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Dunham CM, Brocker BP, Collier BD, et al. Clin Care. 2008;12:1–13.

    Google Scholar 

  50. Bub L, Blackmore C, Mann F, et al. Radiology. 2005;234:143–9.

    Article  PubMed  Google Scholar 

  51. Goode TL, Young A, Wilson SP, et al. Am Surg. 2014;80:182–4.

    PubMed  Google Scholar 

  52. Kokoska E, Keller M, Rallo M, et al. J Pediatr Surg. 2001;36:100–5.

    Article  CAS  PubMed  Google Scholar 

  53. Finch G, Barnes M. J Pediatr Orthop. 1998;18:811–4.

    CAS  PubMed  Google Scholar 

  54. Pieretti-Vanmarcke R, Velmahos G, Nance ML, et al. J Trauma. 2009;67:543–50.

    Article  PubMed  Google Scholar 

  55. Anderson RA, Scaife ER, Fenton SJ, et al. J Neurosurg. 2006;105:361–4.

    Article  PubMed  Google Scholar 

  56. Baker C, Kadish H, Schunk JE. Am J Emerg Med. 1999;17(3):230–4.

    Article  CAS  PubMed  Google Scholar 

  57. Buhs C, Cullen M, Klein M, et al. J Pediatr Surg. 2000;35(6):994–7.

    Article  CAS  PubMed  Google Scholar 

  58. Dwek JR, Chung CB. AJR Am J Roentgenol. 2000;174(6):1617–9.

    Article  CAS  PubMed  Google Scholar 

  59. Ralston ME, Chung K, Barnes PD, et al. Acad Emerg Med. 2001;8(3):237–45.

    Article  CAS  PubMed  Google Scholar 

  60. Silva CT, Doria AS, Traubici J, et al. AJR. 2009;194:500–8.

    Article  Google Scholar 

  61. Adelgais KM, Grossman DC, Langer SG, et al. Acad Emerg Med. 2004;11:228–36.

    Article  PubMed  Google Scholar 

  62. Viccellio P, Simon H, Pressman B, et al. Pediatrics. 2001;108:E20.

    Google Scholar 

  63. National Academy of Science. Health effects of exposure to low levels of ionizing radiation: BEIR VII. Washington, DC: National Academy Press; 2006.

    Google Scholar 

  64. Hernandez JA, Chupik C, Swischuk LE. Emerg Radiol. 2004;10(4):176–8.

    Article  PubMed  Google Scholar 

  65. Keenan HT, Hollingshead MC, Chung CJ, et al. AJR Am J Roentgenol. 2001;177(6):1405–9.

    Article  CAS  PubMed  Google Scholar 

  66. Patel JC, Tepas JJ 3rd, Mollitt DL, et al. J Pediatr Surg. 2001;36(2):373–6.

    Article  CAS  PubMed  Google Scholar 

  67. Cirak B, Ziegfeld S, Knight VM, et al. J Pediatr Surg. 2004;39(4):607–12.

    Article  PubMed  Google Scholar 

  68. Knox JB, Schneider JE, Cage JM, et al. J Pediatr Orthop. 2014;34:698–702.

    Article  PubMed  Google Scholar 

  69. Inaba K, Nosanov L, Menaker J, et al. J Trauma Acute Care Surg. 2015;78:459–67.

    Article  PubMed  Google Scholar 

  70. Beirne J, Butler P, Brady F. Int J Oral Maxillofac Surg. 1995;24:26–9.

    Article  CAS  PubMed  Google Scholar 

  71. Davis RL, Hughes M, Gubler KD, et al. Pediatrics. 1995;95(3):345–9.

    CAS  PubMed  Google Scholar 

  72. Durham RM, Luchtefeld WB, Wibbenmeyer L, et al. Am J Surg. 1995;170(6):681–4.

    Article  CAS  PubMed  Google Scholar 

  73. Cooper C, Dunham CM, Rodriguez A. J Trauma. 1995;38(5):692–6.

    Article  CAS  PubMed  Google Scholar 

  74. Frankel HL, Rozycki GS, Ochsner MG, et al. J Trauma. 1994;37(4):673–6.

    Article  CAS  PubMed  Google Scholar 

  75. Meldon SW, Moettus LN. J Trauma. 1995;39(6):1110–4.

    Article  CAS  PubMed  Google Scholar 

  76. Samuels LE, Kerstein MD. J Trauma. 1993;34(1):85–9.

    Article  CAS  PubMed  Google Scholar 

  77. Stanislas MJ, Latham JM, Porter KM, et al. Injury. 1998;29(1):15–8.

    Article  CAS  PubMed  Google Scholar 

  78. Hsu JM, Joseph T, Ellis AM. Injury. 2003;34(6):426–33.

    Article  PubMed  Google Scholar 

  79. Holmes JF, Panacek EA, Miller PQ, et al. J Emerg Med. 2003;24(1):1–7.

    Article  PubMed  Google Scholar 

  80. Sava J, Williams MD, Kennedy S, et al. J Trauma. 2006;61:168–71.

    Article  PubMed  Google Scholar 

  81. Gestring ML, Gracias VH, Feliciano MA, et al. J Trauma. 2002;53(1):9–14.

    Article  PubMed  Google Scholar 

  82. Wintermark M, Mouhsine E, Theumann N, et al. Radiology. 2003;227(3):681–9.

    Article  PubMed  Google Scholar 

  83. Hauser CJ, Visvikis G, Hinrichs C, et al. J Trauma 2003;55(2):228–34; discussion 34–5.

    Google Scholar 

  84. Sheridan R, Peralta R, Rhea J, et al. J Trauma. 2003;55:665–9.

    Article  PubMed  Google Scholar 

  85. Rhee PM, Bridgeman A, Acosta JA, et al. J Trauma 2002;53(4):663–7; discussion 7.

    Google Scholar 

  86. Karul M, Bannas P, Schoennagel BP, et al. Eur J Radiol. 2013;82:1273–7.

    Article  CAS  PubMed  Google Scholar 

  87. Mancini DJ, Burchard KW, Pekala JS. J Trauma. 2010;69:119–21.

    Article  PubMed  Google Scholar 

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Acknowledgment

Dr. Blackmore wishes to acknowledge the chapters below and his coauthors on these chapters, Dr. J. B. Smith (1) and Dr. G. D. Avey (2). These chapters below were drawn upon for this current chapter in the process of presenting thoroughly updated and significantly revised coverage of this subject for emergency imaging. (1) Blackmore CC, Smith JB. Spine Trauma: Evidence-Based Neuroimaging. In Medina LS, et al., eds: Evidence-Based Neuroimaging Diagnosis and Treatment: Improving the Quality of Neuroimaging in Patient Care. NY: Springer Science; 2013. (2) Blackmore CC, Avey GD. Imaging of the Spine in Victims of Trauma. In Medina LS, et al., eds: Evidence-Based Imaging: Improving the Quality of Imaging in Patient Care. NY: Springer Science; 2011.

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Correspondence to C. Craig Blackmore .

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Blackmore, C.C. (2018). Acute Spine Trauma in Adults and Children: Evidence-Based Emergency Imaging. In: Kelly, A., Cronin, P., Puig, S., Applegate, K. (eds) Evidence-Based Emergency Imaging. Evidence-Based Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-67066-9_11

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  • DOI: https://doi.org/10.1007/978-3-319-67066-9_11

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