Determination of Cervical Spine Stability in Trauma Patients

Two groups of trauma patients were identified for whom the difficulties involved in clearing the cervical spine were different: individuals who were alert, awake, had a normal mental status not altered by drugs or alcohol, and had no distracting pain; and those who had an altered mental status usually due to a closed head injury. The former group was capable of describing the presence or absence of neck pain while the later group was not. This ability was determined, based on the literature, to be very useful in identifying significant cervical spine injuries. For those patients who were alert and awake at the time of evaluation, and had no distracting pain, a large amount of prospectively collected data (over 6,000 trauma patients) suggested that no such patient had a clinically significant cervical spine injury in the absence of neck pain. The Committee therefore concluded that cervical spine radiographs were not necessary for clearance of the cervical spine in these patients.