• Brian M Fisher, Steven Cowles, Jennifer R Matulich, Bradley G Evanson, Diana Vega, and Sharmila Dissanaike.
• Department of Surgery, Mailstop 8312, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, USA.
• Am. J. Surg. 2013 Dec 1;206(6):987-93; discussion 993-4.

BackgroundGuidelines are in place directing the clearance of the cervical spine in patients who are awake, alert, and oriented, but a gold standard has not been recognized for patients who are obtunded. Our study is designed to determine if magnetic resonance imaging (MRI) detects clinically significant injuries not seen on computed tomographic (CT) scans.MethodsThe trauma registry was used to identify and retrospectively review medical records of blunt trauma patients from January 1, 2005, to March 30, 2012. Only obtunded patients with a CT scan and MRI of the cervical spine were included.ResultsThe study cohort consisted of 277 patients. In 13 (5%) patients, MRI detected clinically significant cervical spine injuries that were missed by CT scans, and in 7 (3%) these injuries required intervention. The number needed to screen with MRI to prevent 1 missed injury was 21.ConclusionsThe findings suggest that the routine use of MRI in clearing the cervical spine in the obtunded blunt trauma patient.Copyright © 2013 Elsevier Inc. All rights reserved.

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