ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017
Occult subaxial cervical disco-ligamentous injuries in computer tomography negative trauma patients.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Computed tomography versus magnetic resonance imaging of the cervical spine in the spinal clearance of trauma patients: a systematic review and meta-analyses.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Evaluation, Management, and Return-To-Sport Guidelines for Cervical Spine Injuries in Athletes: A Narrative Review.Global spine journal · 2026Review
- Delayed spinal cord injury after a fall - Case report.Journal of family medicine and primary care · 2025Article
- [Which diagnostic tests are indicated in the emergency department after trauma to the cervical spine?]Unfallchirurgie (Heidelberg, Germany) · 2025Review
- Correlation of clinical and radiological findings in patients with spinal trauma at Inkosi Albert Luthuli Central Hospital.SA journal of radiology · 2025Article
- Clinical significance of "positive" cervical spine MRI findings following a negative CT.Emergency radiology · 2022Article
- Cervical spine clearance after blunt trauma: current state of the art.EFORT open reviews · 2020Review
- Prevertebral Soft-Tissue Swelling at C7 Is Highly Sensitive for Cervical Spine Ligamentous Injury Study Type: Retrospective Cohort Study.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2020Article
- Cervical Disc and Ligamentous Injury in Hyperextension Trauma: MRI and Intraoperative Correlation.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2020Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDue to lack of cervical clearance consensus in literature and the devastating consequences of missed cervical injuries, Magnetic resonance imaging (MRI) of the neurologically intact symptomatic patient with negative CT scan is frequently done to rule out disco-ligamentous injuries. This study retrospectively evaluates occult disco-ligamentous injuries detected by MRI in patients with no abnormalities detected by modern multi-detector CT scanning and postulates a new theory of ligamentous stability of cervical spine.
methodsCervical spine injury patients treated at a spinal trauma referral centre from 2010 to 2013 were retrospectively identified. Available clinical records and radiographic imaging were reviewed to find neurologically intact symptomatic patients with no identifiable acute cervical spine injury on CT scan but MRI evidence of isolated subaxial disco-ligamentous injuries. Patient demographics, injury profile, and treatment details were extracted. Subaxial Cervical Spine Injury Classification (SLIC) and Denis three-column spinal stability theory were adopted to assess stability of injuries.
result316/566 cervical spinal admissions had CT and MRI scans. 11 (3.5%) CT negative patients were found to have occult discoligamentous injuries on MRI. The average age (51.1 years) was not significantly different to all cervical trauma admissions (p = 0.09). Eight had flexion type and three had extension type injuries. The most common mechanisms were sports and fall on flat surface. The average SLIC score was 3.1. Four patients were classified as having unstable or potentially unstable injuries (two patients each) and three of these patients were surgically managed. Subtle CT changes to indicate discoligamentous injury could be retrospectively identified in all four of these patients.
conclusionCT scans alone may be inadequate for clearing occult disco-ligamentous injuries of the subaxial cervical spine in trauma. Denis three-column stability theory may be beneficial in determining stability and guiding treatment along with the SLIC system for occult discoligamentous injuries of the subaxial cervical spine.
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