Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction
Objectives Selective prehospital cervical spine motion restriction (C-SMR) following blunt trauma has increasingly been used by emergency medical service (EMS) providers. We determined rates of prehospital C-SMR and concomitant radiographic injury patterns.Methods A retrospective trauma registry and...
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BMJ Publishing Group
2023-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e001092.full |
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| author | James Vosswinkel Jonathan Martin Zhe Wang Adam J Singer Emily Huang Randeep Jawa Susan Jao Ambika Mukhi Neeta Chaudhary Victoria Yuan Robert Laskowski |
| author_facet | James Vosswinkel Jonathan Martin Zhe Wang Adam J Singer Emily Huang Randeep Jawa Susan Jao Ambika Mukhi Neeta Chaudhary Victoria Yuan Robert Laskowski |
| author_sort | James Vosswinkel |
| collection | DOAJ |
| description | Objectives Selective prehospital cervical spine motion restriction (C-SMR) following blunt trauma has increasingly been used by emergency medical service (EMS) providers. We determined rates of prehospital C-SMR and concomitant radiographic injury patterns.Methods A retrospective trauma registry and chart review was conducted for all adult blunt trauma patients who were transported by EMS and hospitalized with radiographic cervical spine injuries from 2011 to 2019 at a level 1 trauma center.Results Of 658 admitted blunt trauma patients with confirmed cervical spine injury by imaging, 117 (17.8%) did not receive prehospital C-SMR. Patients without prehospital C-SMR were significantly older (76 vs 54 years), more often had low fall as mechanism of injury (59.8% vs 15.9%) and had lower Injury Severity Score (10 vs 17). Patients without C-SMR (Non-SMR) experienced the full array of cervical spine injury types and locations. While the non-SMR patients most often had dens fractures,C-SMR patients most often had C7 fractures; frequencies of fractures at the remaining vertebral levels were comparable. On MRI, cervical spinal cord (8.5% vs 19.6%) and ligamentous injuries (5.1% vs 12.6%) occurred less often in non-SMR patients. Approximately 8.5% of non-SMR patients and 20% of C-SMR patients required cervical spine surgery.Conclusion Patients without prehospital C-SMR demonstrate a broad array of cervical spine injuries. While the rates of certain cervical injuries are lower in prehospital non-SMR patients, they are not insignificant.Level of evidence Level III. |
| format | Article |
| id | doaj-art-ed3d3c312985493d8aac4a869e1b5eae |
| institution | OA Journals |
| issn | 2397-5776 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj-art-ed3d3c312985493d8aac4a869e1b5eae2025-08-20T02:09:55ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-11-018110.1136/tsaco-2023-001092Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restrictionJames Vosswinkel0Jonathan Martin1Zhe Wang2Adam J Singer3Emily Huang4Randeep Jawa5Susan Jao6Ambika Mukhi7Neeta Chaudhary8Victoria Yuan9Robert Laskowski10Stony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USADepartment of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, ChinaEmergency Medicine, Stony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAStony Brook University, Stony Brook, New York, USAObjectives Selective prehospital cervical spine motion restriction (C-SMR) following blunt trauma has increasingly been used by emergency medical service (EMS) providers. We determined rates of prehospital C-SMR and concomitant radiographic injury patterns.Methods A retrospective trauma registry and chart review was conducted for all adult blunt trauma patients who were transported by EMS and hospitalized with radiographic cervical spine injuries from 2011 to 2019 at a level 1 trauma center.Results Of 658 admitted blunt trauma patients with confirmed cervical spine injury by imaging, 117 (17.8%) did not receive prehospital C-SMR. Patients without prehospital C-SMR were significantly older (76 vs 54 years), more often had low fall as mechanism of injury (59.8% vs 15.9%) and had lower Injury Severity Score (10 vs 17). Patients without C-SMR (Non-SMR) experienced the full array of cervical spine injury types and locations. While the non-SMR patients most often had dens fractures,C-SMR patients most often had C7 fractures; frequencies of fractures at the remaining vertebral levels were comparable. On MRI, cervical spinal cord (8.5% vs 19.6%) and ligamentous injuries (5.1% vs 12.6%) occurred less often in non-SMR patients. Approximately 8.5% of non-SMR patients and 20% of C-SMR patients required cervical spine surgery.Conclusion Patients without prehospital C-SMR demonstrate a broad array of cervical spine injuries. While the rates of certain cervical injuries are lower in prehospital non-SMR patients, they are not insignificant.Level of evidence Level III.https://tsaco.bmj.com/content/8/1/e001092.full |
| spellingShingle | James Vosswinkel Jonathan Martin Zhe Wang Adam J Singer Emily Huang Randeep Jawa Susan Jao Ambika Mukhi Neeta Chaudhary Victoria Yuan Robert Laskowski Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction Trauma Surgery & Acute Care Open |
| title | Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| title_full | Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| title_fullStr | Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| title_full_unstemmed | Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| title_short | Radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| title_sort | radiographic cervical spine injury patterns in admitted blunt trauma patients with and without prehospital spinal motion restriction |
| url | https://tsaco.bmj.com/content/8/1/e001092.full |
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