The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients

Ali Y. Mejaddam, Haytham M.A. Kaafarani, Elie P. Ramly, Laura L. Avery, Dante D. Yeh, David R. King, Marc A. De Moya, George C. Velmahos

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance. Methods All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion-extension views, and/or repeat physical examination. Results Of 3,333 patients (40 ± 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion-extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury. Conclusion Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance.

Original languageEnglish (US)
Article number11547
Pages (from-to)822-826
Number of pages5
JournalAmerican journal of surgery
Volume210
Issue number5
DOIs
StatePublished - Nov 2015
Externally publishedYes

Keywords

  • Cervical spine
  • Computed tomography
  • Loss of lordosis
  • Trauma

ASJC Scopus subject areas

  • Surgery

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