Holliman C J, Mayer J S, Cook R T, Smith J S
Department of Surgery, Milton S. Hershey Medical Center, Hershey, PA 17033.
Am J Emerg Med. 1991 Sep;9(5):421-5. doi: 10.1016/0735-6757(91)90206-y.
The usefulness of the anteroposterior (AP) radiograph of the cervical spine in contributing to the diagnosis of cervical spine injuries in the acute trauma patient was examined in a retrospective study. All cases of cervical spine fracture or dislocation seen at a level I trauma center over a 3-year period and at a rehabilitation center over a 10-year period were reviewed. The lateral radiograph, open-mouth odontoid radiograph, and AP radiograph of each case were sequentially examined by a neuroradiologist (blinded to the original diagnosis) to determine the contribution of each view in making a diagnosis of cervical spine injury. Results of these reviews showed that there were no cases of cervical spine injury evident on the AP view without an obvious corresponding abnormality on the lateral or open-mouth view. It was concluded that the AP view could be dropped from the initial screening radiographic study of the cervical spine in the trauma patient. Only an adequate lateral view and open-mouth odontoid view would then be necessary to initially evaluate the cervical spine in the trauma patient, and decisions to obtain further studies could be based safely on only the lateral and open-mouth views.
一项回顾性研究对颈椎前后位（AP）X线片在急性创伤患者颈椎损伤诊断中的作用进行了检查。回顾了在一家一级创伤中心3年期间以及一家康复中心10年期间所见的所有颈椎骨折或脱位病例。一位神经放射科医生（对原诊断不知情）依次检查每个病例的侧位X线片、张口齿状突X线片和前后位X线片，以确定每个视图在颈椎损伤诊断中的作用。这些回顾结果表明，在前后位视图上没有颈椎损伤病例，而在侧位或张口位视图上没有明显相应异常。得出的结论是，在创伤患者颈椎的初始筛查X线研究中可以省略前后位视图。那么，最初评估创伤患者的颈椎仅需要一张足够的侧位视图和张口齿状突视图，并且获取进一步检查的决定可以仅安全地基于侧位和张口位视图。
