INCIDENCE AND RISK FACTORS OF CERVICAL SPINE INJURY IN MILD TRAUMATIC BRAIN INJURY PATIENTS USING COMPUTERIZED TOMOGRAPHY SCAN
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Abstract
BACKGROUND
Nowadays we use the computerized tomography (CT) of the cervical spine to evaluate all patients suspected cervical spine injury in Chiangrai Prachanukroh Hospital. We observe that there is over investigation in patient with mild traumatic brain injury. Physical examination and risk factors of these patients may be useful to differentiate a patient with and without traumatic brain injury and to make decision of further investigation.
OBJECTIVE
To study the incidence and risk factors of cervical spine injury in patients with mild traumatic brain injury using CT scan
METHODS
Retrospective cross sectional study of mild traumatic brain injury patients in Chiangrai Prachanukroh Hospital with CT cervical spine from 1 January 2019 – 31 December 2019 was conducted. Clinical data from medical records and CT images from PACS were reviewed. The data were analyzed by using student t-test, Wilcoxon rank sum test, Exact probability test and logistic regression with statistical significance at p<0.05.
RESULTS
135 patents of 554 patients with mild traumatic injury had cervical spine injury (24.37%). Risk factors effect cervical spine injury were showed in the table.
Risk factors
Adjusted Odds Ratio
95% CI
p-value
Male
2.14
1.29-3.68
0.002
Tenderness at cervical spine
11.77
3.04-100.42
< 0.001
Cannot active neck flexion
2.92
1.89-4.54
< 0.001
Focal neurological deficit
4.70
2.58-8.57
< 0.001
Prevertebral soft tissue swelling
14.15
6.32-34.58
< 0.001
Vertebral fusion
3.01
1.17-7.63
0.007
Degenerative change
1.73
1.14-2.62
0.006
No cervical spine injury was observed in patients who did not meet NEXUS or Canadian C-spine rule study criteria
CONCLUSIONS AND DISCUSSIONS
Mild traumatic brain injury patents who had risk factors of cervical spine injury or met NEXUS or Canadian C-spine rule study criteria should be performed CT cervical spine to evaluate cervical spine injury.
Article Details
References
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