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The daunting task of “clearing” the cervical spine

Published online by Cambridge University Press:  11 May 2015

Brian E. Grunau ,
Daniel Dibski  and
Jeremy Hall
Brian E. Grunau*
Affiliation:
Emergency Department, St. Paul's Hospital and Department of Emergency Medicine, University of British Columbia, Vancouver, BC
Daniel Dibski
Affiliation:
Emergency Department, Chilliwack General Hospital, Chillwack, BC
Jeremy Hall
Affiliation:
Emergency Department, Chilliwack General Hospital, Chillwack, BC
*
Emergency Department, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6; briangrunau@gmail.com.

Abstract

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The evaluation of the cervical spine in the emergency department is a common and often challenging task. We report the case of a 70-year-old female who presented intoxicated with evidence of a recent fall. A 64-slice computed tomographic (CT) scan with sagittal and coronal reconstructions revealed no acute injury. The patient was reexamined when alert and had persistent neck pain. Flexionextension static views revealed severe subluxation of C5 on C6 with jumped facets, and subsequent magnetic resonance imaging confirmed significant ligamentous injury. The evidence available suggests that although CT with reconstruction is highly sensitive for clinically significant cervical injury, the possibility of severe injury remains.

Keywords

cervicalcomputed tomographyimagingspinetrauma
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 3 , March 2012 , pp. 187 - 192
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

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