X-rays are used in conjunction with the clinical examination to "clear" the c-spine in patients who present with mul tiple trauma, head injuries with neck pain, and those who have altered levels of consciousness and unknown injuries. Recently, the "Canadian C-spine Rule" was published to help identify patients who may NOT require a c-spine x-ray.A lateral c-spine view can detect 60% to 80% of fractures. Anterior posterior(A-P) and open-mouth odon toid views improve the sensitivity to 80% to 95% or better. For those of us who only occasionally interpret c-spine films, oblique views can make it much easier to detect certain injuries. Occa sionally, fractures poorly seen on other views will be seen with flexion or extension. Adding a CT scan increases the sensitivity to 95% to 100%; how ever, plain films are better than CT for detecting some injuries.
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