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Usefulness of full spine computed tomography in cases of high-energy trauma: a prospective study

  • Masanari TakamiEmail author
  • Kazuhiro Nohda
  • Junya Sakanaka
  • Masamichi Nakamura
  • Munehito Yoshida
Original Article

Abstract

Introduction

At this hospital, computed tomography (CT) of the full spine is performed on all patients who have sustained high-energy trauma because spinal fractures can be overlooked by referring only to clinical findings and plain X-rays of the spine. The goal of this study is to prospectively detect the occurrence of spinal fractures in cases of high-energy trauma using full spine CT and to evaluate the usefulness of it.

Materials and methods

Subjects were 179 patients (134 male, 45 female) who were deemed to have sustained high-energy trauma in the 21-month period starting in September 2007. Spinal fractures initially revealed by CT were studied in detail.

Results

Spinal fractures were found in 54 patients (30.2 %); 19 patients had stable fractures, and 41 had unstable fractures. Forty patients had concomitant injuries to organs in addition to spinal injury; these patients had an average Injury Severity Score of 20.2 (4–70). Of 16 patients with a cervical fracture, 6 (37.5 %) had a fracture that did not appear on plain X-rays of the cervical and that was first identified by CT. Of 43 patients with a thoracolumbar fracture, 6 (14.0 %) had a fracture that would have been difficult to detect if a full spine CT had not been done.

Conclusion

In patients who have sustained high-energy trauma, spinal fractures may be overlooked during primary care by a diagnosis based only on plain X-rays and clinical manifestations. Therefore, patients who have sustained high-energy trauma should be evaluated with full spine CT during primary care.

Keywords

Full spine computed tomography (CT) Spine fractures Prospective study High-energy trauma Imaging management Primary survey 

Notes

Conflict of interest

All authors have received no benefits or funds in support of this study.

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Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • Masanari Takami
    • 1
    • 2
    Email author
  • Kazuhiro Nohda
    • 1
  • Junya Sakanaka
    • 1
  • Masamichi Nakamura
    • 1
  • Munehito Yoshida
    • 1
  1. 1.Department of Orthopaedic SurgeryWakayama Medical UniversityWakayamaJapan
  2. 2.Department of Critical Care MedicineWakayama Medical UniversityWakayamaJapan

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