Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?

The purpose of the study was to determine the role of magnetic resonance imaging (MRI) in intubated multitrauma patients with normal computed tomography (CT) in excluding unstable ligamentous injury to the cervical spine. A retrospective evaluation was done on those multitrauma patients admitted to the intensive care unit of a level 1 trauma centre who had normal single-slice helical CT cervical spine and underwent MRI for cervical spine clearance from 1/1/04 to 30/6/05. Fifty-five patients met the inclusion criteria. Ten of these patients had a discoligamentous injury identified on MRI; however, all these patients had injuries limited to only one of the three columns of the cervical spine. Single-slice helical CT with sagittal reformats had a negative predictive value of 82% for discoligamentous injury and 100% for unstable injury. A normal single-slice helical CT with sagittal reformats of the cervical spine in intubated trauma patients excluded unstable injuries at follow-up cervical spine MR imaging.