Dvorak J
Neurologische Abteilung der Schulthess-Klinik Zürich.
Schweiz Med Wochenschr. 1990 Dec 29;120(51-52):1989-98.
Over 3000 cases of soft tissue injuries of the cervical spine are reported annually to SUVA (Swiss accident insurance). Although the majority of the patients are pain-free within 4 weeks, it appears that approximately a quarter of those injured still experience neck pain even years after the accident. The initial radiological assessment should include an AP and a lateral plain X-ray of the cervical spine, and in the case of radicular symptomatology oblique views are also recommended. Should the symptoms persist for more than 6-8 weeks after the accident, functional X-rays in flexion/extension and lateral flexion should also be performed. If no instability can be demonstrated by plain X-rays and symptoms are still present and severe enough to limit the patient's working capacity after 3 to 6 months despite conservative therapy, further neuroradiological investigations, including functional CT's, are indicated. The decision to perform these investigations should lie with an interdisciplinary spinal team. Close cooperation between the clinicians and the radiologists is of utmost importance to ensure that the optimal radiological investigation can be performed on the basis of the clinical findings.
每年向瑞士意外事故保险机构（SUVA）报告的颈椎软组织损伤病例超过3000例。尽管大多数患者在4周内疼痛消失，但似乎约四分之一的伤者即使在事故多年后仍会经历颈部疼痛。初始放射学评估应包括颈椎前后位和侧位平片，若出现神经根症状，还建议拍摄斜位片。如果事故发生6至8周后症状仍持续，也应进行颈椎屈伸位及侧屈位功能X线检查。若平片未显示不稳定，且症状仍然存在，尽管经过保守治疗，但3至6个月后仍严重到足以限制患者工作能力时，则需进行进一步的神经放射学检查，包括功能CT检查。是否进行这些检查应由跨学科脊柱团队决定。临床医生和放射科医生之间的密切合作对于确保根据临床发现进行最佳放射学检查至关重要。
