Evaluation of cervical spine injuries in polytraumatized patients in Emergency Service
Abstract
Introduction: The screening for cervical spine injuries in polytraumatized patients has traditionally consisted in neurological clinical examination and radiographic evaluation. In different trauma centers, the initial evaluation of these patients, being awake and conscious, includes neurological clinical examination and radiographs, even if they present a normal semiology. This is due to the belief that clinical examination is insufficient for the detection of these lesions. Materials and Methods: This is a cross-sectional and observational study to determine the sensitivity and specificity of the clinical examination for the diagnosis of cervical spine injuries, comparing imaging studies over a 22-month period in an emergency unit. Results: During this period, 127 patients were assisted. In 101 patients, the neurological and physical examination was normal. No injuries were recorded when performing radiographs or CT scans on these patients. During examination, 26 patients felt pain after palpation of the spinous processes. After a CT scan, 6 of these patients were found to have a cervical spine injury. The sensitivity of the physical examination was 100% and the specificity was 83%. The false positive rate was 17% and no false negatives were recorded. Conclusions: The data from this study shows that the majority of studies by imaging, radiographs or CT scans could be reduced, without losing the sensitivity of cervical spine injuries diagnoses, and thus reducing the costs of care.Level of Evidence: IVDownloads
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