Evaluation of acute cervical spine imaging based on ACR Appropriateness Criteria®.

Publication Type	Academic Article
Authors	Sheikh K, Belfi L, Sharma R, Baad M, Sanelli P
Journal	Emerg Radiol
Volume	19
Issue	1
Pagination	11-7
Date Published	11/06/2011
ISSN	1438-1435
Keywords	Cervical Vertebrae, Practice Guidelines as Topic, Tomography, X-Ray Computed, Wounds, Nonpenetrating
Abstract	The objectives of this study were to determine the rate of acute blunt cervical spine injury at an academic urban level 1 trauma center and to evaluate the utilization of cervical spine imaging based on the established American College of Radiology (ACR) Appropriateness Criteria®. We retrospectively reviewed all radiography and CT imaging of the cervical spine performed over a year period in adult patients presenting with acute blunt cervical spine trauma. Exclusion criteria were children ≤17 years, non-acute trauma of ≥72 h, and penetrating trauma. Any fracture, dislocation, or ligamentous instability demonstrated by diagnostic imaging and requiring stabilization or specialized follow-up was defined as clinically significant cervical spine injury. A total of 1,325 cervical spine studies were reviewed in 1,245 patients; 32.7% (433/1,325) were cervical spine radiographs and 67.3% (892/1,325) were CT examinations. Approximately 1.5% (19/1,245) of the patients demonstrated clinically significant acute cervical spine injury. There were 6.4% (80/1,245) patients who received both cervical spine radiographs and CT as imaging evaluation. Based on the ACR Appropriateness Criteria®, all of the cervical spine radiographs performed (433) were determined to be "inappropriate" imaging in the setting of acute cervical spine injury.
DOI	10.1007/s10140-011-0994-z
PubMed ID	22057542