The two main causes of an unstable cervical spine injury are:Ĭervical spine fractures encompass a broad array of injury patterns, creating a spectrum of morbidity from benign yet painful conditions to permanent disability and death. Which can result in neurologic injury including paralysis if not immobilized and treated appropriately. One of the most feared causes of neck pain in the trauma patient is an unstable cervical spine injury, Neck pain is a common occurrence in the trauma patient, and as Emergency Medicine clinicians, it is our role to identify serious pathologies. Describe indications for further diagnostic imaging of the cervical spine. Describe the next steps after a cervical spine fracture is discovered on imaging.Understand the best imaging modality to evaluate for cervical spine fractures.Describe the clinical decision rules to determine the indication for cervical spine imaging in the emergency department.Your suspicion for a cervical spine fracture is low, but you wonder if you still have to obtain imaging since he has cervical spine bony tenderness.īy the end of this module, the you will be able to: On exam, his vital signs are reassuring, he is neurologically intact and not intoxicated, and has diffuse but mild midline cervical spine Loss of consciousness, was able to walk immediately after the accident, and is only complaining of neck pain. He was a restrained driver on a residential street when the car in front of him suddenly stopped, causing him to strike their rear bumper. Written by: Steven Lindsey, MD, Emory University Department of Emergency MedicineĮditor: Navdeep Sekhon, MD, Baylor College of MedicineĪ 32 year-old man presents to the Emergency Department after being involved in a motor vehicle accident. SAEMF/CDEM Innovations in Undergraduate Emergency Medicine Education GrantĬareer Development and Mentorship CommitteeĬDEM Medical Education Fellow Travel Scholarship Virtual Rotation and Educational ResourcesĮMF/SAEMF Medical Student Research Training Grant In some clinics and hospitals, X-ray pictures can be shown right away on a computer screen.Visit us on Twitter LinkedIn Facebook YouTube Instagram You will wait about 5 minutes until the X-rays are processed in case more pictures need to be taken. How long the test takesĪ spinal X-ray usually takes about 15 minutes. You need to lie very still to avoid blurring the pictures. If you have a neck brace (cervical collar) in place, X-ray pictures may be taken and a physical exam done to see whether the brace can be taken off without hurting the spine. This is done to prevent causing more injury. If the X-ray is being taken because of a possibly serious injury to your neck or back, a radiologist will look at the first X-ray pictures before taking others. You may be allowed to keep on your underwear if it does not get in the way of the test.ĭuring the X-ray test, you will lie on an X-ray table. You will be given a cloth or paper gown to use during the test. You may need to take off some of your clothes, depending on which area is examined. You will need to remove any jewelry that may be in the way of the X-ray picture. The most common spinal X-rays are of the cervical vertebrae (C-spine films) and lumbosacral vertebrae (LS-spine films). It takes a detailed view of the 5 fused bones at the bottom of the spine (sacrum) and the 4 small bones of the tailbone (coccyx). It takes pictures of the 5 bones of the lower back (lumbar vertebrae) and a view of the 5 fused bones at the bottom of the spine (sacrum). It takes pictures of the 12 chest (thoracic) bones. It takes pictures of the 7 neck (cervical) bones. So there are four common types of spinal X-rays: Spinal X-rays are also done to check the curve of your spine ( scoliosis) or for spinal defects. These problems may include spinal fractures, infections, dislocations, tumors, bone spurs, or disc disease. They may be taken to find injuries or diseases that affect the discs or joints in your spine.
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