Cervical spine radiography after blunt trauma. Is it always needed?

In trauma cases, the mere presence of a cervical immobilization device is not an indication for radiography of the cervical spine. High-yield radiographic criteria have been prospectively determined for cases of blunt trauma, and these identify individuals at low risk for cervical spine injuries. Cervical spine radiography is not required for patients who are alert, cooperative, and nonintoxicated and do not have neurologic deficits, cervical signs or symptoms, antecedent spinal mobility disorders, or distracting injuries. Cervical spine radiography alone does not ensure detection of all injuries. Adequate history taking and careful examination are always essential and may dictate additional studies.