• Can J Surg · Oct 2004

    Review

    Assessment of stability of the cervical spine in blunt trauma patients: review of the literature, with presentation and preliminary results of a modified traction test protocol.

    • Drew A Bednar, Badriya Toorani, Matthew Denkers, and Hesham Abdelbary.
    • Division of Orthopedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. spinopod@allstream.net
    • Can J Surg. 2004 Oct 1;47(5):338-42.

    ObjectiveTo review the reported efficacy of various imaging techniques in assessing stability of the neck in blunt trauma patients, and to present the protocol and preliminary results of a modified traction test protocol.DesignThis is a prospective cohort study.SettingA regional trauma unit in Southern Ontario.PatientsPeople with blunt-trauma injuries who came to the author's consultant practice with "C-spine not cleared" status, from January 2001 through December 2003.InterventionsA fluoroscopically controlled test of axial traction followed by flexion/extension stressing.Outcome MeasuresRadiographic confirmation of the absence of pathological motion under load.ResultsIn 51 cases studied to date, no instabilities have been found. Four cases of minor ligamentous hypermobility have been detected, with stability confirmed and no surgery required. There have been no failures to depict the neck completely, no missed instabilities and no complications of the procedure.ConclusionsCervical stability can be reliably confirmed with this test without any requirement for advanced imaging technology.

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