The Inefficiency of Plain Radiography to Evaluate the Cervical Spine After Blunt Trauma

Evaluation of the Intervertebral Disk Angle for the Assessment of Anterior Cervical Diskoligamentous Injury

“…Although flexion/extension radiography is useful in the gauging of potential cervical spine instability, it can be difficult to perform in the setting of cervical spine trauma and has been shown to have low usefulness in the evaluation of potential diskoligamentous injury. [21][22][23][24][25] Normative data have been published regarding the upper limits of acceptable prevertebral soft tissue thickness on CT scan, 26 and spinous process widening on plain film 27 ; however, neither normative data regarding disk widening nor objective criteria for evaluation of potential ADL disruption have been published. Therefore, when evaluating the ADL on CT scan, radiologists are forced to rely on a subjective assessment of disk widening.…”

Reassessment of the Craniocervical Junction: Normal Values on CT

“…1 A recent study has demonstrated that standard cervical spine radiographs are inadequate to fully evaluate the cervical spine after blunt trauma. 10 Meanwhile, the use of CT for the evalu- ation of the cervical spine has grown rapidly since the advent of helical and multidetector scanners. In many institutions, including our own, it is now the examination used in the initial assessment of an acutely traumatized patient, rather than a standard radiographic evaluation.…”

Normal Thickness and Appearance of the Prevertebral Soft Tissues on Multidetector CT

“…In our experience, the normal values based on radiographic studies are commonly used in multidetector CT (MDCT) images, despite the fact that differences in the acquisition of these images could account for significant differences in their normal values. With the widespread replacement of standard radiographic evaluation of the cervical spine by MDCT, 4,[7][8][9][10] it is necessary to establish normal values for the thickness of the PVST on MDCT images.…”