Helical CT in the primary trauma evaluation of the cervical spine: an evidence-based approach |
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Authors: | C Craig Blackmore Frederick A Mann Anthony J Wilson |
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Institution: | (1) Department of Radiology, Harborview Medical Center, University of Washington, Seattle, Washington, USA, US;(2) Center for Cost and Outcomes Research, University of Washington, Seattle, Washington, USA, US;(3) Department of Radiology, Box 359728, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104-2499, USA, US;(4) Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA, US |
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Abstract: | This review provides a summary of the cost-effectiveness, clinical utility, performance, and interpretation of screening helical
cervical spine CT for trauma patients. Recent evidence supports the use of helical CT as a cost-effective method for screening
the cervical spine in high-risk trauma patients. Screening cervical spine CT can be performed at the time of head CT to lower
the cost of the evaluation, and when all short- and long-term costs are considered, CT may actually save money when compared
with traditional radiographic screening. In addition to having higher sensitivity and specificity for cervical spine injury,
CT screening also allows more rapid radiological clearance of the cervical spine than radiography. Patients who are involved
in high-energy trauma, who sustain head injury, or who have neurological deficits are candidates for CT screening. Screening
with CT may enhance detection of other potentially important injuries of the cervical region.
Received: 17 March Revision requested: 14 April 2000 Revision received: 19 July 2000 Accepted: 19 July 2000 |
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Keywords: | Cervical spine screening CT scan Trauma Cost-effectiveness Cervical spine fracture Clinical predictors |
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