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Background: Cervical spine injuries have an increased rate of injury and death in cases of delayed diagnosis. Computer tomography is an appropriate and popular tool for evaluating patients suspected of cervical spine injuries.
Objectives: To study the radiographic characteristics of the cervical spine and to assess the suitability of the cervical spine X-ray examination according to the criteria for evaluating patients at the emergency department at Sisaket Hospital
Study design: Retrospective descriptive study.
Methods: Cervical spine injury patients at the emergency department of Sisaket Hospital from 1st. July 2018 to 31st. January 2019 and undergo a computer scan on the cervical spine without injecting opaque substances. The patients who injured by sharp or shot objects or injured more than three days were excluded in this study. Data was collected from out-patient and in-patient medical records. The data collected were age, sex, important symptoms, causes of injury, indication for the examination of the cervical spine, interpretation record by radiologists. The data were analyzed by using descriptive statistics, reporting as frequency, percentage.
Results: Cervical spine injury patients at the Emergency Department, Sisaket Hospital from 1st July 2018 to 31st January 2019 and undergoing a computerized examination of the cervical spine according to the criteria, a total of 342 cases, 300 patients, 87.7% had an indication of examination according to NEXUS. The most criteria were Alteration of consciousness (44.4%), followed by Midline cervical tenderness (25.1%). There were 42 patients, 12.3% of whom were CT without an indication record. Report found no abnormality, 310 cases (90.6%) and 32 cases had abnormalities (9.4%), age range <18 years, 37 persons found no abnormalities, aged 18-65 years, detected abnormalities 10.6 %, age range> 65 years detected abnormalities 9.8 %. The most abnormal found at the level of lower cervical spine. Patients aged >18 years, 108 cases were study both CT and plain radiograph and 10 were found to have abnormalities from both studies. No abnormalities were detected from plain radiograph alone.
Conclusion: A rigorous assessment of patients with cervical spine injuries using the NEXUS criteria and the selection of radiography in pediatric patients could reduce unnecessary computer tomography.
Keywords: Cervical spine CT, blunt cervical spine trauma, NEXUS.
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