Is CT Plus MRI Better Than CT Alone for Cervical Spine Evaluation?

Dispute continues about whether computed tomography (CT) alone is sufficient to discover ligamentous as well as bony cervical spine (C-spine) injury. These authors evaluated whether magnetic resonance imaging (MRI) is needed for C-spine clearance in patients with blunt trauma who have unreliable neurologic examination. Investigators used a single hospital’s trauma registry to identify 203 patients (mean age, 42.3; 67% men) without obvious neurologic deficits who had unreliable clinical examinations (defined by Glasgow Coma Scale score ≤14) and underwent MRI after C-spine CT with normal findings. During the study period (August 2004 to December 2005), hospital guidelines stipulated that patients with persistently unreliable clinical examinat…