Development of a new clinical decision rule for cervical CT to detect cervical spine injury in patients with head or neck trauma

摘要

Objective Previous cervical spine imaging decision rules have been based on positive findings on plain X-ray and are limited by lack of specificity, age restrictions and complicated algorithms. We previously derived and validated a clinical decision rule (Rule 1) for detecting cervical spine injury (CSI) on CT in a single-centre study. This recommended CT for patients with (1) GCS score 14, (2) GCS 14-15 and posterior cervical tenderness or neurological deficit, (3) age = 60 years and fall down stairs, or (4) age 60 and injured in a motorcycle collision or fallen from height. This study assessed the accuracy and reliability of this rule and refined the rule.