Cervical magnetic resonance imaging abnormalities not predictive of cervical spine instability in traumatically injured patients

Eric Horn, Gregory P. Lekovic, Iman Feiz-Erfan, Volker K H Sonntag, Nicholas Theodore

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Object. Identifying instability of the cervical spine can be difficult in traumatically injured patients. The goal of this study was to determine whether cervical abnormalities demonstrated on magnetic resonance (MR) imaging are predictive of spinal instability. Methods. Data in all patients admitted through the Level I trauma service at the authors' institution who had undergone cervical MR imaging were retrospectively reviewed. The reasons for MR imaging screening were neurological deficit, fracture, neck pain, and indeterminate clinical examination (for example, coma). Abnormal soft-tissue (prevertebral or paraspinal) findings on MR imaging were correlated with those revealed on computerized tomography (CT) scanning and plain and dynamic radiography to determine the presence/absence of cervical instability. Of 6328 patients admitted through the trauma service, 314 underwent MR imaging of the cervical spine. Of 166 patients in whom CT scanning or radiography demonstrated normal findings, 70 had undergone MR imaging that revealed abnormal findings. Of these 70 patients, 23 underwent dynamic imaging, the findings of which were normal. In each case of cervical instability (65 patients) CT, radiographic, and MR imaging studies demonstrated abnormalities. Furthermore, there were 143 patients with abnormal CT or radiographic study findings, in 13 of whom MR imaging revealed normal findings. Six of the latter underwent dynamic testing, which demonstrated normal results. Conclusions. Magnetic resonance imaging is sensitive to soft-tissue injuries of the cervical spine. When CT scanning and radiography detect no fractures or signs of instability, MR imaging does not help in determining cervical stability and may lead to unnecessary testing when not otherwise indicated.

Original languageEnglish (US)
Pages (from-to)39-42
Number of pages4
JournalJournal of Neurosurgery
Volume101
Issue number1 SUPPL.
StatePublished - Jul 2004
Externally publishedYes

Fingerprint

Spine
Magnetic Resonance Imaging
X Ray Tomography
Radiography
Tomography
Soft Tissue Injuries
Neck Pain
Wounds and Injuries
Coma

Keywords

  • Cervical spine
  • Dynamic radiography
  • Magnetic resonance imaging
  • Spinal injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Surgery
  • Neurology

Cite this

Cervical magnetic resonance imaging abnormalities not predictive of cervical spine instability in traumatically injured patients. / Horn, Eric; Lekovic, Gregory P.; Feiz-Erfan, Iman; Sonntag, Volker K H; Theodore, Nicholas.

In: Journal of Neurosurgery, Vol. 101, No. 1 SUPPL., 07.2004, p. 39-42.

Research output: Contribution to journalArticle

Horn, Eric ; Lekovic, Gregory P. ; Feiz-Erfan, Iman ; Sonntag, Volker K H ; Theodore, Nicholas. / Cervical magnetic resonance imaging abnormalities not predictive of cervical spine instability in traumatically injured patients. In: Journal of Neurosurgery. 2004 ; Vol. 101, No. 1 SUPPL. pp. 39-42.
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abstract = "Object. Identifying instability of the cervical spine can be difficult in traumatically injured patients. The goal of this study was to determine whether cervical abnormalities demonstrated on magnetic resonance (MR) imaging are predictive of spinal instability. Methods. Data in all patients admitted through the Level I trauma service at the authors' institution who had undergone cervical MR imaging were retrospectively reviewed. The reasons for MR imaging screening were neurological deficit, fracture, neck pain, and indeterminate clinical examination (for example, coma). Abnormal soft-tissue (prevertebral or paraspinal) findings on MR imaging were correlated with those revealed on computerized tomography (CT) scanning and plain and dynamic radiography to determine the presence/absence of cervical instability. Of 6328 patients admitted through the trauma service, 314 underwent MR imaging of the cervical spine. Of 166 patients in whom CT scanning or radiography demonstrated normal findings, 70 had undergone MR imaging that revealed abnormal findings. Of these 70 patients, 23 underwent dynamic imaging, the findings of which were normal. In each case of cervical instability (65 patients) CT, radiographic, and MR imaging studies demonstrated abnormalities. Furthermore, there were 143 patients with abnormal CT or radiographic study findings, in 13 of whom MR imaging revealed normal findings. Six of the latter underwent dynamic testing, which demonstrated normal results. Conclusions. Magnetic resonance imaging is sensitive to soft-tissue injuries of the cervical spine. When CT scanning and radiography detect no fractures or signs of instability, MR imaging does not help in determining cervical stability and may lead to unnecessary testing when not otherwise indicated.",
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