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Imaging suspected cervical spine injury: plain radiography or computed tomography? Systematic review
journal contribution
posted on 2023-07-26, 12:49 authored by Gavin Cain, Jane Shepherdson, Vicki Elliott, Jon Svensson, Patrick BrennanAim:
(1) to establish which modality offers the greatest accuracy in the detection of cervical spine injury (CSI) Following trauma: plain radiography or computed tomography (CT), and (2) make an evidence-based recommendation for the initial imaging modality of choice.
Method:
A systematic literature review was performed to identify primary research studies which compare the diagnostic accuracy of plain radiography and CT with the results of a reference standard in the detection of CSI. A search of MEDLINE, EMBASE, CINAHL, Science Direct and Pubmed Central databases was conducted.
Results:
Ten studies were identified. Critical appraisal identified limitations among all studies. There was heterogeneity in the sensitivity estimates for plain radiography, whereas estimates for CT were consistently high. Examination of the reported sensitivities shows that CT outperforms plain radiography in the detection of CSI.
Conclusion:
CT is superior to plain radiography in the detection of CSI. However, the optimal imaging strategy depends on the patients' relative risk of injury. If at high-risk cervical CT is indicated. If at low-risk the increased cost and radiation exposure mean that screening CT may not be warranted, good-quality plain radiographs are sufficient.
History
Refereed
- Yes
Volume
16Issue number
1Page range
68-77Publication title
RadiographyISSN
1532-2831External DOI
Publisher
ElsevierLanguage
- other
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Legacy posted date
2011-09-20Legacy Faculty/School/Department
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