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Evaluation of acute cervical spine imaging based on ACR Appropriateness Criteria®

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Abstract

The objectives of this study were to determine the rate of acute blunt cervical spine injury at an academic urban level 1 trauma center and to evaluate the utilization of cervical spine imaging based on the established American College of Radiology (ACR) Appropriateness Criteria®. We retrospectively reviewed all radiography and CT imaging of the cervical spine performed over a year period in adult patients presenting with acute blunt cervical spine trauma. Exclusion criteria were children ≤17 years, non-acute trauma of ≥72 h, and penetrating trauma. Any fracture, dislocation, or ligamentous instability demonstrated by diagnostic imaging and requiring stabilization or specialized follow-up was defined as clinically significant cervical spine injury. A total of 1,325 cervical spine studies were reviewed in 1,245 patients; 32.7% (433/1,325) were cervical spine radiographs and 67.3% (892/1,325) were CT examinations. Approximately 1.5% (19/1,245) of the patients demonstrated clinically significant acute cervical spine injury. There were 6.4% (80/1,245) patients who received both cervical spine radiographs and CT as imaging evaluation. Based on the ACR Appropriateness Criteria®, all of the cervical spine radiographs performed (433) were determined to be “inappropriate” imaging in the setting of acute cervical spine injury.

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Authors and Affiliations

  1. Department of Radiology, NewYork-Presbyterian Hospital–Weill Cornell Medical College, 525 East 68th Street, Starr 630B, New York, NY, 10065, USA

    Kiran Sheikh, Lily M. Belfi, Michael Baad & Pina C. Sanelli

  2. Department of Emergency Medicine, NewYork-Presbyterian Hospital–Weill Cornell Medical College, 525 East 68th Street, Room M-130, New York, NY, 10065, USA

    Rahul Sharma

  3. Department of Public Health, NewYork-Presbyterian Hospital–Weill Cornell Medical College, 525 East 68th Street, Starr 630B, New York, NY, 10065, USA

    Pina C. Sanelli

Authors
  1. Kiran Sheikh
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  2. Lily M. Belfi
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  3. Rahul Sharma
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  4. Michael Baad
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  5. Pina C. Sanelli
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Correspondence to Kiran Sheikh.

Additional information

This publication was made possible by Grant Number 5K23NS058387-02 from the National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NINDS or NIH.

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Sheikh, K., Belfi, L.M., Sharma, R. et al. Evaluation of acute cervical spine imaging based on ACR Appropriateness Criteria®. Emerg Radiol 19, 11–17 (2012). https://doi.org/10.1007/s10140-011-0994-z

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  • DOI: https://doi.org/10.1007/s10140-011-0994-z

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