The Western Trauma Association (WTA) reported criteria for cervical spine clearance in a trauma patient. The authors are from multiple institutions in the United States and members of the Western Trauma Association.
Patient selection: trauma patient with rigid cervical collar
Parameters:
(1) patient examination (active range of motion, midline cervical pain or tenderness, focal neurological deficit, spine deformity
(2) screening neck CT
(3) diagnostic neck CT
(4) MRI C-spine
Exam
Screening Neck CT
Diagnostic Neck CT
MRI C-Spine
Interpretation
normal
NA
NA
NA
remove collar
abnormal
NA
no fracture
no ligament or spinal cord injury
remove collar
abnormal
NA
no fracture
ligament or spinal cord injury
spine consultation
abnormal
NA
C-spine fracture
NA
spine consultation
unable to do
normal neck CT
NA
NA
remove collar
unable to do
abnormal with no fracture
NA
ligament or spinal cord injury
spine consultation
unable to do
abnormal with no fracture
NA
no ligament or spinal cord injury
remove collar
unable to do
C spine fracture
NA
NA
spine consultation
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