Cervical MRI in Obtunded Trauma Patients Does Not Change Management After Normal CT

Can the cervical spine be considered “cleared” of significant injury after normal cervical spine computed tomography (CT) in multitrauma patients with abnormal mental status? Researchers retrospectively analyzed data from 150 obtunded patients (Glasgow Coma Scale score ≤13) without gross neurological deficits who underwent magnetic resonance imaging (MRI) of the cervical spine after normal CT scans (16-slice scanner) at a single level I trauma center over a 5-year period. Mean time between CT and MRI studies was 2.13 days.

MRI scans were normal in 51% of patients. Most positive MRI findings (82%) were ligamentous or soft tissue injuries. Disc protrusions were detected in 12% of patients and noncompressive subdural or epidural hematomas were …