Lawrence Christopher, Radmard Mahla, Tafazolimoghadam Armin, Amoah Akua Afrah, Lakhani Dhairya A, Azadi Javad, Chanmugam Arjun, Yousem David M
From the Russell H. Morgan Department of Radiology and Radiological Science (C.L., M.R., D.A.L., J.A., D.M.Y.), Johns Hopkins Medical Institution, Baltimore, Maryland.
Tehran University of Medical Sciences (A.T.), Tehran, Iran.
AJNR Am J Neuroradiol. 2025 Apr 2;46(4):820-822. doi: 10.3174/ajnr.A8542.
The Canadian Cervical Spine Rule, a clinical decision-making tool for patients post-trauma, is often interpreted as recommending cervical spine CT in patients ≥65 years old, who sustain a dangerous mechanism of injury, and/or have extremity paresthesias. We retrospectively reviewed 6 years' of emergency department cervical spine CT reports to determine fracture rates in patients ≥65, symptomatic or not, who did and did not have a dangerous mechanism. Of those ≥65 years old, 240 of 13,925 (1.72%) patients had cervical spine fractures. The fracture rate in asymptomatic patients ≥65 was 0.27%. The fracture rate in asymptomatic patients ≥65, who did not have a dangerous mechanism of injury was 0.15%. The rate of unstable fractures requiring surgery was 0.007%. The findings suggest that the algorithm to scan asymptomatic patients ≥65, and/or those ≥65 without a dangerous injury mechanism, should be revisited for appropriateness and overall value.
加拿大颈椎规则是一种用于创伤后患者的临床决策工具，通常被解释为建议对65岁及以上、遭受危险损伤机制和/或有肢体感觉异常的患者进行颈椎CT检查。我们回顾性分析了6年的急诊科颈椎CT报告，以确定65岁及以上有或无危险机制的有症状或无症状患者的骨折率。在65岁及以上的患者中，13925例中有240例（1.72%）发生颈椎骨折。65岁及以上无症状患者的骨折率为0.27%。65岁及以上无危险损伤机制的无症状患者的骨折率为0.15%。需要手术的不稳定骨折率为0.007%。研究结果表明，对于65岁及以上无症状患者和/或无危险损伤机制的65岁及以上患者进行扫描的算法，应重新评估其适用性和总体价值。
