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News & Press: Trauma-Watch Industry News

The MRI Enigma in Spine Injury Clearance

Tuesday, September 2, 2014  
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Removing a cervical collar in the early aftermath of a traumatic injury is becoming an increasingly difficult task. With ever more sensitive imaging modalities we have progressively devalued the traditional methods used to evaluate the integrity of the spinal column in favor of more technologically advanced ones.  Despite decades of success in treating this pathology and clear evidence that clinically relevant spinal injuries present with obvious clinical signs, we have let anecdotal evidence get the best of us. With this in mind, we now turn to the enigma that is the neurologically intact patient with persistent midline tenderness with no evidence of pathology on cervical CT.  As previously concluded, in the neurologically intact patient with persistent midline tenderness, MRI identifies far more injuries than CT. In a cohort of 178 prospectively gathered patients with isolated persistent midline tenderness and a negative CT, Auckland et al. reported 78 (44%) with injuries identified on MRI. Although the majority required no intervention, 33 (18.5%) required use of a collar and five (2.8%) required surgical management. These findings taken at face value are concerning to say the least, and do not fit with our clinical experience. In fact, there is reasonable evidence demonstrating this increased signal found on MRI is merely the noise of an overly sensitive test applied to an extraordinarily low-risk population.  Click here to read moreā€¦..

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