C-Spine MRI

Aka: C-Spine MRI, MRI C-Spine, Cervical Spine MRI

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II. Indications: MRI C-Spine in Trauma

  1. SCIWORA suspected (neurologic deficits with normal imaging)
    1. Most often associated with pediatric C-Spine Injury, but also occurs in adults
  2. Central Cord Syndrome suspected (symmetric upper extremity > lower extremity neurologic deficits)
    1. Inaba (2016) J Trauma Acute Care Surg 81(6):1122-30 +PMID:27438681 [PubMed]
  3. Vascular neck injury suspected
    1. Severe blunt force neck injury
    2. Significant hyperextension or hyperflexion injury
    3. Unexplained neurologic deficits
    4. Skull base Fracture
    5. Cervical Vertebral Fracture in region of Vertebral arteries
    6. Penetrating neck injury in region of neck vascular structures
    7. Severe Facial Fractures
  4. Obtunded patients (or otherwise unreliable exams)
    1. Most studies have found no management-changing findings on MRI that were not seen on CT
      1. Como (2007) J Trauma 63(3): 544-49 [PubMed]
      2. Harris (2008) Spine 33(14): 1547-53 [PubMed]
      3. Tomycz (2008) J Trauma 64(5): 1258-63 [PubMed]
      4. Hogan (2005) Radiology 237(1):106-13 [PubMed]
    2. Only the Menaker group has found significant benefits to MRI over C-Spine in obtunded patients
      1. Menaker (2010) Am Surg 76(2): 157-63 [PubMed]
      2. Menaker (2008) J Trauma 64(4): 898-903 [PubMed]

III. References

  1. Jang and Kaji (2013) Crit Dec Emerg Med 27(6): 2-9
  2. Bagley (2006) Radiol Clin North Am 44(1): 1-12 [PubMed]

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