Ethical approval for the study was deemed not necessary by the National Research Ethics Service, a part of the NHS Research Ethics Committee.

This was a retrospective study conducted in 2 busy district hospitals over a 3 month period. The aim of our study was to assess the reduction in cervical spine radiography rates if the Canadian Cervical spine rule was retrospectively applied to patients who had cervical spine radiographs following blunt trauma to the neck. Comparison between the decision rules revealed the Canadian Cervical Spine rule to be more sensitive and specific. This increased use of cervical spine radiographs exposes the patient to unnecessary radiation.Ģ decision rules available in the literature to guide the use of cervical spine radiographs are the Canadian Cervical Spine rule (CCS) and the National Emergency X-radiography Utilisation Study (NEXUS). There is no uniformity in requesting for cervical spine radiographs with variations ranging up to six-fold. Cervical spine radiographs in these group of patients are negative for fractures in more than 98%. Studies have shown that the incidence of an acute fracture or spinal injury following a blunt trauma to the neck in a neurologically intact patient who has been mobile after the incident is less than 1%. Is this practice acceptable in the present day? This has lead to clinicians utilising cervical spine radiographs liberally. A missed significant cervical spine injury can lead to disastrous consequences for the patient. There has always been a cautious outlook towards suspected cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs. ConclusionĪpplying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4%) would not have needed cervical spine radiograph. 86 patients fell into the low risk category. ResultsĢ8 patients were included in the high risk category according to the Canadian Cervical Spine rule. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. This was a retrospective study conducted in 2 hospitals. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients.

Consequently there has been an increased use of cervical spine radiography. A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries.

Davis series cervical spine x rays