Imaging of the Cervical Spine > Technique > Importance of Prompt Diagnosis

Indications

Who needs radiographic studies of the cervical spine?

Indications for X-ray are:

1. Mental status less than alert or intoxicated
2. Reports neck pain
3. Midline neck tenderness
4. Neurologic signs and symptoms
5. Distracting injury (i.e. painful injuries elsewhere, e.g. extremity fractures)

Not all trauma patients with a significant injury need c-spine films. Criteria for excluding cervical spine fractures on a clinical basis are: no neck pain, no neck tenderness on palpation, having full, painless, active range of motion of c-spine, no history of loss of consciousness, no mental status change, no neurologic deficit from neck injury, and no distracting symptoms. If patient meets all these criteria, cervical spine injury is excluded on clinical basis and the cervical collar may be removed.

Question: A patient arrived at the ED on backboard and a cervical collar. He has a blood alcohol level of 0.2. He does not complain of any neck pain. Shoud he get a complete cervical series? (push the button for answer)