TY - JOUR
T1 - ACR Appropriateness Criteria ® Suspected Spine Trauma
AU - Expert Panel on Neurological Imaging and Musculoskeletal Imaging:
AU - Beckmann, Nicholas M.
AU - West, O. Clark
AU - Nunez, Diego
AU - Kirsch, Claudia F.E.
AU - Aulino, Joseph M.
AU - Broder, Joshua S.
AU - Cassidy, R. Carter
AU - Czuczman, Gregory J.
AU - Demertzis, Jennifer L.
AU - Johnson, Michele M.
AU - Motamedi, Kambiz
AU - Reitman, Charles
AU - Shah, Lubdha M.
AU - Than, Khoi
AU - Ying-Kou Yung, Elizabeth
AU - Beaman, Francesca D.
AU - Kransdorf, Mark J.
AU - Bykowski, Julie
N1 - Publisher Copyright:
© 2019 American College of Radiology
PY - 2019/5
Y1 - 2019/5
N2 - Injuries to the cervical and thoracolumbar spine are commonly encountered in trauma patients presenting for treatment. Cervical spine injuries occur in 3% to 4% and thoracolumbar fractures in 4% to 7% of blunt trauma patients presenting to the emergency department. Clear, validated criteria exist for screening the cervical spine in blunt trauma. Screening criteria for cervical vascular injury and thoracolumbar spine injury have less validation and widespread acceptance compared with cervical spine screening. No validated criteria exist for screening of neurologic injuries in the setting of spine trauma. CT is preferred to radiographs for initial assessment of spine trauma. CT angiography and MR angiography are both acceptable in assessment for cervical vascular injury. MRI is preferred to CT myelography for assessing neurologic injury in the setting of spine trauma. MRI is usually appropriate when there is concern for ligament injury or in screening obtunded patients for cervical spine instability. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - Injuries to the cervical and thoracolumbar spine are commonly encountered in trauma patients presenting for treatment. Cervical spine injuries occur in 3% to 4% and thoracolumbar fractures in 4% to 7% of blunt trauma patients presenting to the emergency department. Clear, validated criteria exist for screening the cervical spine in blunt trauma. Screening criteria for cervical vascular injury and thoracolumbar spine injury have less validation and widespread acceptance compared with cervical spine screening. No validated criteria exist for screening of neurologic injuries in the setting of spine trauma. CT is preferred to radiographs for initial assessment of spine trauma. CT angiography and MR angiography are both acceptable in assessment for cervical vascular injury. MRI is preferred to CT myelography for assessing neurologic injury in the setting of spine trauma. MRI is usually appropriate when there is concern for ligament injury or in screening obtunded patients for cervical spine instability. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - AUC
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Cervical
KW - Neurologic injury
KW - Spine
KW - Thoracolumbar
KW - Trauma
KW - Vascular injury
UR - http://www.scopus.com/inward/record.url?scp=85064494429&partnerID=8YFLogxK
U2 - 10.1016/j.jacr.2019.02.002
DO - 10.1016/j.jacr.2019.02.002
M3 - Article
C2 - 31054754
AN - SCOPUS:85064494429
SN - 1546-1440
VL - 16
SP - S264-S285
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 5
ER -