Cervical X-ray versus CT scan: Radiologic Findings in Traumatic Cervical Spine Injury in Emergency Department

Abstract

Objective: Head and neck trauma are among the most common reasons for referring to hospitals’ emergency departments. This study aimed to compare cervical X-ray and CT scans’ accuracy in diagnosing cervical spine injuries in trauma patients in Shahroud city.Materials and Methods: The present study is a cross-sectional study on patients with traumatic cervical injuries referred to the emergency department of Imam Hossein Hospital in Shahroud city from 2018 to 2019. Both cervical X-rays and CT scans were used for all patients. Firstly, the radiography, then CT scans were performed. An emergency medicine specialist and a radiologist examined crvical X-rays and CT scans separately for diagnosing cervical spine injuries. In this paper, CT scan findings were considered as the gold standard. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood were used to determine the diagnostic value of plain radiography compared to CT scan. The Kappa agreement coefficient was also calculated.Results: Out of 115 participants, 7.8% (9 patients) had cervical spine injuries period 59.1% were male, and 40.9% were female. The mean age of patients was 39.8 ± 15.3 years. Car accidents, rollover, and motorcycle accidents with 39.1, 24.3, and 20.9%, respectively, were the most common mechanisms of causing injuries in these patients. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratios for cervical X-ray were 55.56, 97.17, 62.5, 26.26, 96, 19.63, and 0.46%, respectively.Conclusion: According to the present study results, the accuracy of cervical X-ray compared to CT scan in diagnosing injuries occurred to the cervical spine due to trauma is low because the sensitivity of cervical X-rays in detecting injuries is very low. Therefore, it seems that the cervical X-ray cannot be considered as a suitable tool to rule out cervical spine injuries caused by trauma.