Brohi Karim, Healy Marie, Fotheringham Tim, Chan Otto, Aylwin Chris, Whitley Siobhan, Walsh Michael
Department of Trauma Surgery, Royal London Hospital, London, United Kingdom.
J Trauma. 2005 May;58(5):897-901. doi: 10.1097/01.ta.0000171984.25699.35.
Assessment of the spine in the unconscious trauma patient is limited by an inadequate clinical examination. The potential of a missed unstable disc or ligamentous injury results in many patients remaining immobilized in critical care units for prolonged periods.
This study evaluates helical computed tomographic (CT) scanning of the whole cervical spine as part of a spinal assessment and clearance protocol.
Four hundred thirty-seven unconscious, intubated, blunt trauma patients underwent CT scanning of the cervical spine. Sixty-one patients had a cervical spine injury and 31 (7.0%) were unstable. CT scanning had a sensitivity of 98.1%, a specificity of 98.8%, and a negative predictive value of 99.7%. There were no missed unstable injuries. In contrast, an adequate lateral cervical spine film detected only 24 injuries (14 unstable), with a sensitivity of 53.3%.
Helical CT scanning of the cervical spine allows rapid and safe evaluation of the cervical spine in the unconscious, intubated trauma patient.
在无意识创伤患者中，由于临床检查不充分，对脊柱的评估受到限制。漏诊不稳定椎间盘或韧带损伤的可能性导致许多患者在重症监护病房长期保持固定体位。
本研究评估了全颈椎螺旋计算机断层扫描（CT）作为脊柱评估和排除方案的一部分。
437例无意识、插管的钝性创伤患者接受了颈椎CT扫描。61例患者有颈椎损伤，其中31例（7.0%）不稳定。CT扫描的敏感性为98.1%，特异性为98.8%，阴性预测值为99.7%。没有漏诊不稳定损伤。相比之下，一张合格的颈椎侧位片仅检测到24例损伤（14例不稳定），敏感性为53.3%。
颈椎螺旋CT扫描能够对无意识、插管的创伤患者的颈椎进行快速、安全的评估。
