Evaluation of the cervical spine in the obtunded patient

Assessment of cervical spine stability in the posttraumatic obtunded patient can be difficult to accomplish with currently available imaging modalities. Dynamic fluoroscopy during passive flexion and extension has been proposed by some authors as a method for the evaluation of cervical spine stability. We present our experience with dynamic fluoroscopy, the general opinions of multiple trauma centers, and alternative methods for evaluating cervical spine stability in the obtunded patient. The potential risks and problems associated with each method are discussed.