Evaluation of the use of plain cervical spine radiography in patients with head injury.

The records of 457 head trauma patients who underwent plain cervical spine radiography following head injury between January 1991 and December 1991 inclusive were reviewed. Seventy-six patients (17%) all above ten years of age had abnormalities; forty five were clinically suspected to have cervical spine injury because of cervical tenderness and/or neurological deficits and in the remaining thirty-one patients the cervical spine injuries were detected first on plain radiograph. The 31 vertebral injuries consisted off fracture-dislocations 12 fractures, 4 dislocations and one odontoid fracture. None of the 235 patients below the age of 10 years had cervical vertebral or cord injury. It is recommended that plain cervical spine radiography be performed on all patients with head injury associated with altered level of consciousness and who are above ten years of age.