• Meltem Songür Kodik, Cenk Eraslan, Ömer Kitiş, Yusuf Ali Altuncı, Hüseyin Biçeroğlu, and Ali Akay.
• Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir-Turkey.
• Ulus Travma Acil Cer. 2020 May 1; 26 (3): 431-438.

BackgroundThis study aimed to investigate the role of computed tomography (CT) in identifying missed unstable blunt cervical injuries.MethodsPatients admitted to the emergency department between June 2014 and June 2018 with a diagnosis of blunt cervical trauma were included in this study. All participants underwent cervical magnetic resonance imaging (MRI) after an initial cervical CT investigation. All imaging results were reviewed, and decisions were taken by the consensus of a team consisting of an emergency medicine specialist, a neuroradiologist, and a neurosurgeon. Other variables included age, sex, the Glasgow Coma Scale, medical comorbidities, multi-trauma, neurological deficits, accompanying intracranial hemorrhage, extremity fractures, and the mechanism of the injury.ResultsData for 195 patients were analyzed. The mean (±standard deviation) age of the participants was 47.34±21.90 years, and 140 (71.8%) were males. Eighteen patients (9.2%) were below age <18. The most frequent mechanism of injury was fall from height (n=100; 51.3%). Using MRI as the gold standard, the sensitivity of CT in diagnosing unstable cervical injury was 77.7% (95% CI [67.1-86.1]), while its specificity was 100.0% (95% CI [59.0-100.0]).ConclusionAlthough computed tomography is relatively good in diagnosing unstable cervical injuries, its sensitivity in detecting positive cases is not as successful. Thus, the use of MRI in patients with an unstable injury seems to be warranted.

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