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Cervical Spine Injury

A Clinical Decision Rule to Identify High-Risk Patients for Helical CT Screening

Julian A. Hanson1, C. Craig Blackmore1,2, Frederick A. Mann1 and Anthony J. Wilson1

1 Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Ave, Seattle, WA 98104.
2 Department of Radiology, University of North Carolina, Manning Dr., Chapel Hill, NC 27599.



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  		Fig. 1A —Screening helical CT technique used to evaluate for cervical and upper thoracic spine trauma. Lateral cervical and upper thoracic scan projection shows levels and angulation for helical CT coverage. Reconstruction interval = 1.5 mm.

 


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  		Fig. 1B —Screening helical CT technique used to evaluate for cervical and upper thoracic spine trauma. Midline sagittal reformation obtained from helical data set shows upper cervical spine.

 


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  		Fig. 2. —Decision tree shows radiologic screening yields according to imaging to technique and patient subset (direct admission to Harborview Medical Center [HMC] or transfer). +ve = true-positive study for cervical spine injury.

 

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