Neurosurg Focus
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The author maintained prospective records on every patient he treated during the 26 years of his neurosurgical private practice. At the conclusion of his clinical career, he compiled this information in a formal database program and then analyzed the results for totals, trends, and interesting conclusions, which are presented herein.
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A rule for identifying patients with traumatic brain injury (TBI) who are at exceptionally low risk of cervical spine injury might be clinically useful. The goal in this study was to research case records to determine whether such a rule would be practicable. ⋯ No acceptable rule for relaxation of vigilance in the search for cervical spine injury among patients with severe TBI has been identified. Levels of provider vigilance and consequent rates of overlooked cervical spine injury can be affected by environmental cues and presumably by other behavioral and organizational factors.