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SPECIAL INTEREST ARTICLE Initial Radiographic Evaluation of the Spine After Trauma: When, What, Where, and How to Image the Acutely Traumatized Spine John C. France, MD,* Christopher M. Bono, MD,† and Alexander R. Vaccaro, MD‡ here are a number of factors that influence the decision to Background: Radiographic evaluation of the spine after an acute T pursue spinal radiographs in a patient presenting to an traumatic event is an integral part of the initial assessment of the emergency ward. These include mechanism of injury, spinal patient. Despite this, an imaging protocol that includes detailed rec- pain or tenderness, concomitant non-spinal injuries that can ommendations of the views, modalities, and techniques of radio- distract the patient from spine complaints injuries, neurologic graphic work-up is lacking in the peer-reviewed literature. symptoms or deficits, and the mental status of the patient. In the best-case scenario, a patient may present with a history and Study Purpose: The goal of the current review was to suggest examination that enables clinical ‘‘clearance’’ of the spine a uniform protocol for initial imaging in the traumatized patient and 2,3 without radiographic imaging. This includes a patient who: provide a rationale and guidelines to assist in deciding which
Journal of Orthopaedic Trauma – Wolters Kluwer Health
Published: Oct 1, 2005
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