MRI Is Not Needed for Cervical Spine Clearance in Obtunded Blunt Trauma Patients

A systematic review found no significant missed injuries in obtunded blunt trauma patients who had normal CT imaging of their cervical spines.

Given the significant morbidity and mortality associated with missed traumatic cervical spine injuries, patients in whom a reliable clinical exam is unobtainable are often evaluated with magnetic resonance imaging (MRI) following a normal computed tomography (CT) scan. A number of small studies have demonstrated that this practice does not affect outcomes (NEJM JW Emerg Med Dec 2007 and J Trauma 2007; 63:538; NEJM JW Emerg Med Apr 2012 and J Trauma 2012; 72:699; NEJM JW Emerg Med Jan 2012 and Ann Emerg Med 2011; 58:521); however, none has led to a change in this practice. These authors performed a systematic review to determine the utility of MRI after normal CT results in blunt trauma patients who were obtunded (Glasgow Coma Scale score ≤1…

Reviewing Author

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

MRI Is Not Needed for Cervical Spine Clearance in Obtunded Blunt Trauma Patients

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Reviewing Author