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Assessment of stability of the cervical spine in blunt trauma patients: review of the literature, with presentation and preliminary results of a modified traction test protocol.钝性创伤患者颈椎稳定性评估：文献综述及改良牵引试验方案的介绍与初步结果
Can J Surg. 2004 Oct;47(5):338-42.
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Clinical examination in complement with computed tomography scan: an effective method for identification of cervical spine injury.临床检查辅以计算机断层扫描：一种识别颈椎损伤的有效方法。
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Diagnostic imaging of cervical spine injuries following blunt trauma: a review of the literature and practical guideline.钝性创伤后颈椎损伤的诊断影像学：文献回顾与实用指南。
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Magnetic resonance imaging is not needed to clear cervical spines in blunt trauma patients with normal computed tomographic results and no motor deficits.对于计算机断层扫描结果正常且无运动功能障碍的钝性创伤患者，无需进行磁共振成像来排除颈椎损伤。
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Clinical algorithm for preventing missed diagnoses of occult cervical spine instability after acute trauma: A case report.急性创伤后预防隐匿性颈椎不稳漏诊的临床算法：病例报告
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本文引用的文献

1
Validity of a decision rule to reduce cervical spine radiography in elderly patients with blunt trauma.一项减少钝性创伤老年患者颈椎X线摄影的决策规则的有效性。
Ann Emerg Med. 2002 Sep;40(3):287-93. doi: 10.1067/mem.2002.125708.
2
Some complications of common treatment schemes of thoracolumbar spine fractures can be predicted with magnetic resonance imaging: prospective study of 53 patients with 71 fractures.
Spine (Phila Pa 1976). 2002 Mar 15;27(6):629-36. doi: 10.1097/00007632-200203150-00012.
3
Flexion and extension views are not cost-effective in a cervical spine clearance protocol for obtunded trauma patients.
J Trauma. 2002 Jan;52(1):54-9. doi: 10.1097/00005373-200201000-00011.
4
The Canadian C-spine rule for radiography in alert and stable trauma patients.用于清醒且病情稳定的创伤患者的加拿大颈椎影像学检查规则。
JAMA. 2001 Oct 17;286(15):1841-8. doi: 10.1001/jama.286.15.1841.
5
Prospective comparison of admission computed tomographic scan and plain films of the upper cervical spine in trauma patients with altered mental status.对意识状态改变的创伤患者入院时颈椎计算机断层扫描和平片的前瞻性比较。
J Trauma. 2001 Oct;51(4):663-8; discussion 668-9. doi: 10.1097/00005373-200110000-00007.
6
Ligamentous injuries of the cervical spine in unreliable blunt trauma patients: incidence, evaluation, and outcome.不可靠钝性创伤患者颈椎韧带损伤：发生率、评估及结果
J Trauma. 2001 Mar;50(3):457-63; discussion 464. doi: 10.1097/00005373-200103000-00009.
7
Evaluation of the cervical spine in the polytrauma patient.多发伤患者颈椎的评估
Spine (Phila Pa 1976). 2000 Nov 15;25(22):2884-91; discussion 2892. doi: 10.1097/00007632-200011150-00008.
8
Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group.一套用于排除钝性创伤患者颈椎损伤的临床标准的有效性。国家急诊X线摄影应用研究组。
N Engl J Med. 2000 Jul 13;343(2):94-9. doi: 10.1056/NEJM200007133430203.
9
Sensitivity of prevertebral soft tissue measurement of C3 for detection of cervical spine fractures and dislocations.C3椎体前方软组织测量对颈椎骨折和脱位检测的敏感性。
Am J Emerg Med. 1998 Jul;16(4):346-9. doi: 10.1016/s0735-6757(98)90124-3.
10
Identifiable risk factors for secondary neurologic deterioration in the cervical spine-injured patient.颈椎损伤患者继发性神经功能恶化的可识别危险因素。
Spine (Phila Pa 1976). 1995 Nov 1;20(21):2293-7. doi: 10.1097/00007632-199511000-00006.

钝性创伤患者颈椎稳定性评估：文献综述及改良牵引试验方案的介绍与初步结果

Assessment of stability of the cervical spine in blunt trauma patients: review of the literature, with presentation and preliminary results of a modified traction test protocol.

作者信息

Bednar Drew A, Toorani Badriya, Denkers Matthew, Abdelbary Hesham

机构信息

Division of Orthopedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont.

出版信息

Can J Surg. 2004 Oct;47(5):338-42.

PMID:15540685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3211942/
Abstract

OBJECTIVE

To review the reported efficacy of various imaging techniques in assessing stability of the neck in blunt trauma patients, and to present the protocol and preliminary results of a modified traction test protocol.

DESIGN

This is a prospective cohort study.

SETTING

A regional trauma unit in Southern Ontario.

PATIENTS

People with blunt-trauma injuries who came to the author's consultant practice with "C-spine not cleared" status, from January 2001 through December 2003.

INTERVENTIONS

A fluoroscopically controlled test of axial traction followed by flexion/extension stressing.

OUTCOME MEASURES

Radiographic confirmation of the absence of pathological motion under load.

RESULTS

In 51 cases studied to date, no instabilities have been found. Four cases of minor ligamentous hypermobility have been detected, with stability confirmed and no surgery required. There have been no failures to depict the neck completely, no missed instabilities and no complications of the procedure.

CONCLUSIONS

Cervical stability can be reliably confirmed with this test without any requirement for advanced imaging technology.

摘要

目的

回顾各种影像学技术在评估钝性创伤患者颈部稳定性方面所报道的疗效，并介绍一种改良牵引试验方案的流程及初步结果。

设计

这是一项前瞻性队列研究。

地点

安大略省南部的一个地区创伤中心。

患者

2001年1月至2003年12月期间因“颈椎未排除损伤”状态前来作者顾问诊所就诊的钝性创伤患者。

干预措施

在荧光透视控制下进行轴向牵引试验，随后进行屈伸应力试验。

观察指标

影像学证实负荷下无病理性活动。

结果

迄今为止研究的51例病例中，未发现不稳定情况。检测到4例轻微韧带活动过度，稳定性得到确认，无需手术。颈部均能完整显示，无漏诊的不稳定情况，且该操作无并发症。

结论

使用该试验无需先进影像学技术即可可靠地确认颈椎稳定性。