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Determining the best method for clearing the cervical spine (C-spine) in obtunded blunt trauma patients, particularly for cervical ligamentous injury and cord injury, is a conundrum. Failing to identify injuries can be catastrophic, and keeping patients in hard cervical collars for prolonged periods leads to decubiti and infection. Two recent studies addressed this issue.
Researchers conducted a prospective observational study of 115 obtunded blunt trauma patients who had normal 16-slice helical computed tomography (CT) scans of the neck and underwent magnetic resonance imaging (MRI) of the C-spine during a 2-year period at a single level I trauma center. Patients were defined as obtunded at the discretion of the treating physician. Patients…