Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 18:2021:6658679.
doi: 10.1155/2021/6658679. eCollection 2021.

Prediction Score for Cervical Spine Fracture in Patients with Traumatic Neck Injury

Natsinee Athinartrattanapong  1 , Chaiyaporn Yuksen  1 , Sittichok Leela-Amornsin  1 , Chetsadakon Jenpanitpong  1 , Sirote Wongwaisayawan  2 , Pittavat Leelapattana  3
Affiliations

Prediction Score for Cervical Spine Fracture in Patients with Traumatic Neck Injury

Natsinee Athinartrattanapong et al. Neurol Res Int. .

Abstract

Background: Cervical spine fracture is approximately 2%-5%. Diagnostic imaging in developing countries has several limitations. A computed tomography scan is not available 24 hours and not cost-effective. This study aims to develop a clinical tool to identify patients who must undergo a computed tomography scan to evaluate cervical spine fracture in a noncomputed tomography scan available hospital.

Methods: The study was a diagnostic prediction rule. A retrospective cross-sectional study was conducted between August 1, 2016, and December 31, 2018, at the emergency department. This study included all patients aged over 16 years who had suspected cervical spine injury and underwent a computed tomography scan at the emergency department. The predictive model and prediction scores were developed via multivariable logistic regression analysis.

Results: 375 patients met the criteria. 29 (7.73%) presented with cervical spine fracture on computed tomography scan and 346 did not. Five independent factors (i.e., high-risk mechanism of injury, paraparesis, paresthesia, limited range of motion of the neck, and associated chest or facial injury) were considered good predictors of C-spine fracture. The clinical prediction score for C-spine fracture was developed by dividing the patients into three probability groups (low, 0; moderate, 1-5; and high, 6-11), and the accuracy was 82.52%. In patients with a score of 1-5, the positive likelihood ratio for C-spine fracture was 1.46. Meanwhile, those with a score of 6-11 had an LR+ of 7.16.

Conclusion: In a noncomputed tomography scan available hospital, traumatic spine injuries patients with a clinical prediction score ≥1 were associated with cervical spine fracture and should undergo computed tomography scan to evaluate C-spine fracture.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Two-way bar graph of the C-spine fracture score: CT (+) (n = 29) versus CT (−) (n = 346).
Figure 2
Figure 2
Area under the receiver operating characteristic (AUROC) curve of the clinical risk score and 95% confidence interval (95% CI) for the prediction of cervical spine fracture.
Figure 3
Figure 3
Observed risk (circle) versus score-predicted risk (solid line) of cervical spine fracture.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kanwar R., Delasobera B. E., Hudson K., Frohna W. Emergency department evaluation and treatment of cervical spine injuries. Emergency Medicine Clinics of North America. 2015;33(2):241–282. doi: 10.1016/j.emc.2014.12.002. - DOI - PubMed
    1. Hoffman J. R., Mower W. R., Wolfson A. B., Todd K. H., Zucker M. I. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. New England Journal of Medicine. 2000;343(2):94–99. doi: 10.1056/nejm200007133430203. - DOI - PubMed
    1. Stiell I. G., Wells G. A., Vandemheen K. L., Clement C. M., Lesiuk H., De Maio V. J. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001;286(15):1841–1848. doi: 10.1001/jama.286.15.1841. - DOI - PubMed
    1. Clayton J. L., Harris M. B., Weintraub S. L., et al. Risk factors for cervical spine injury. Injury. 2012;43(4):431–435. doi: 10.1016/j.injury.2011.06.022. - DOI - PubMed
    1. Tins B. J. Imaging investigations in spine trauma: the value of commonly used imaging modalities and emerging imaging modalities. Journal of Clinical Orthopaedics and Trauma. 2017;8(2):107–115. doi: 10.1016/j.jcot.2017.06.012. - DOI - PMC - PubMed

LinkOut - more resources