ABSTRACT
Background Neurologically intact blunt trauma patients with persistent neck pain and negative computed tomography (CT) imaging frequently undergo magnetic resonance imaging (MRI) for evaluation of occult cervical spine injury. There is a paucity of data to support or refute this practice. This study was therefore performed to evaluate the utility of cervical spine MRI in neurologically intact blunt trauma patients with negative CT imaging.
Methods A retrospective review was performed of all neurologically intact blunt trauma patients presenting to a level 1 trauma center from 2005 to 2015 with persistent neck pain and negative CT imaging. The proportion of patients with positive MRI findings, subsequent treatment, and time required to obtain MRI results was evaluated.
Results Of 223 patients meeting inclusion criteria, 11 had positive MRI findings; however, no patients were found to have unstable injuries requiring surgical treatment. The process for a complete evaluation of unstable cervical spine injury from the time of obtaining a CT scan was 19 hours and 43 minutes.
Conclusions Eleven patients had positive MRI findings, yet these findings did not alter treatment. In contrast, the time required to obtain MRI results may substantially delay patient care.
Level of Evidence IV (retrospective case series)
Clinical Relevance Our results demonstrate that MRI has limited utility in neurologically intact blunt trauma patients with negative CT imaging.
- blunt trauma
- cervical spine
- magnetic resonance imaging
- computed tomography
- occult injury
- posterior elements
- unstable
- ligamentous
Footnotes
Disclosures and COI: The authors received no funding for this study. Dr. Klineberg has worked as a consultant for DePuy Synthes Spine, Stryker, and Medicrea. He has also received honoraria and a fellowship grant for University of California, Davis, from AOSpine. Dr. Javidan has received honoraria and a fellowship grant for University of California, Davis from AOSpine. He has worked as a consultant for NuVasive, Alphatec, and Stryker, holds stocks in Alphatec, and has served as a consultant for Medicrea. Drs. Fennessy, Wick, Scott, and, Roberto have no potential or perceived conflicts of interest.
- This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2020 ISASS
