The Cervical Spine: The Iconoclasm Continues

In recent blogs I suggested that clinically significant C spine injuries can be excluded by CT scan in the intoxicated patient and Luke Lawton raised the suggestion that the hard collar may not be as efficacious as we were led to believe in our youth. One of the questions that the C spine blog attracted…

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Cervical spine clearance in the intoxicated patient

The most commonly used c spine clearance rules exclude or mandate imaging in the case of the “intoxicated” patient, and there is debate as to whether a normal CT C spine is adequate to clear the neck of the intoxicated patient in blunt trauma.(1,2) Many clinicians advocate either waiting for intoxicants to clear before clinically…

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Asymptomatic Cervical Fractures in The Elderly

A new study is about to be published which questions the use of current cervical spine clearance criteria in the elderly(1). It goes further, recommending  “liberal c-spine imaging for older trauma patients with significant mechanism of trauma”. Here is a typical case: 74 year old patient from home, has had a mechanical fall from a…

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Clearing the Cervical Spine in Children

Introduction Most of our treatment strategy  in young children is based on our clinical judgement. The evidence on clearing cervical spines, in those older than 18 years, is clear, validated, accepted and is duty of care. The evidence for clearing the cervical spine is not as clear.  It is even more obscure for less than 8 year…

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