Validity of Prevertebral Soft Tissue Measurement in Cervical Spine Injury Patient

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Uthen Pandee
Suparerk Vitsiri
Pichaya Thongpo
Teerarat Tassanapitikul


Background: Cervical radiographs were the initial screening in patients who present with blunt cervical spine (C-spine) injury. The cervical prevertebral soft tissue measurement generally used as screening test in Emergency Department (ED). Many criterias were mentioned in the literatures but the comparison of the validity of the measurements wasn’t concluded.

Objective: To compare validity of cervical prevertebral soft tissue measurement criteria in C-spine injury patients.

Methods: Retrospective reviewed of cervical radiographs measurement patient who suspected C-spine injury from January 2005 to August 2011. The prevertebral soft tissue thickness were measure from C2 to C7 according to criteria from literatures then compared with the final diagnosis by computerize tomography (CT) scan. The results were applied for validation of the criteria.

Results: There were 127 patients in this study. Ninety four (74%) were male. Fifty six (44.1%) patients had c-spine fracture in final diagnosis. The measurement criteria of prevertebral soft tissue C3 > 5 mm, showed the most valid predictability tool, by specificity 73%, sensitivity 49% and area under the receiver operating characteristics (AOC) curve was 0.72 respectively.

Conclusion: Measurement of prevertebral soft tissue has fair ability to detect C-spine injury. Our study suggests the criteria of C3 prevertebral soft tissue > 5 mm has high sensitivity and may be consider to be used as screening test. However, patients whom c-spine injury are suspected should have further investigation especially CT-scan to finalize diagnosis.



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How to Cite
Pandee, U., Vitsiri, S., Thongpo, P., & Tassanapitikul, T. (2017). Validity of Prevertebral Soft Tissue Measurement in Cervical Spine Injury Patient. Ramathibodi Medical Journal, 40(2), 16-24. Retrieved from
Original Articles


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