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Clinical Assessment of Acute Cervical Spine Trauma | Chiropractor Penrith

In a recent meta-analysis of 65 studies including almost 282 000 trauma patients, it was found that cervical spine injury occurs in 3.7% of patients overall, with 2.8% of alert patients and 7.7% of altered level of consciousness patients having an acute abnormality detected. Of the patients with cervical spine injury identified, 42% were found to have fracture, dislocation or pure discoligamentous injury requiring external immobilisation or operative stabilisation.

In acute severe trauma a thorough history of the traumatic incident should be sought before clinical evaluation, including mechanism of injury, state of consciousness, focal neurological signs and general symptoms. The assessment can then follow either the National Emergency X-Radiography Utilisation Study (NEXUS) guidelines or the Canadian C-spine Rule. The sensitivity, specificity and negative predictive value of the NEXUS criteria to clinically significant cervical spine injury was reported as 99.6%, 12.9% and 99.9% respectively, while the Canadian C-spine rule was reported as 100% sensitive and 42.5% specific to clinically important injury.
 

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