Relationship of Mechanism of Injury to Asymptomatic Cervical Spine Fractures in the Elderly Publisher Pubmed



Lawrence C¹ ; Radmard M¹ ; Tafazolimoghadam A⁴ ; Amoah AA² ; Lakhani DA¹ ; Azadi J¹ ; Chanmugam A³ ; Yousem DM¹ Show Affiliations
Source: American Journal of Neuroradiology Published:2025

Abstract

The Canadian Cervical Spine Rule, a clinical decision-making tool for patients post-trauma, is often interpreted as recommending cervical spine CT in patients $65 years old, who sustain a dangerous mechanism of injury, and/or have extremity paresthesias. We retrospectively reviewed 6 years’ of emergency department cervical spine CT reports to determine fracture rates in patients $65, symptomatic or not, who did and did not have a dangerous mechanism. Of those $65 years old, 240 of 13,925 (1.72%) patients had cervical spine fractures. The fracture rate in asymptomatic patients $65 was 0.27%. The fracture rate in asymptomatic patients $65, who did not have a dangerous mechanism of injury was 0.15%. The rate of unstable fractures requiring surgery was 0.007%. The findings suggest that the algorithm to scan asymptomatic patients $65, and/or those $65 without a dangerous injury mechanism, should be revisited for appropriateness and overall value. © 2025 American Society of Neuroradiology. All rights reserved.