How Precise Are CT Scans for Detecting Upper Cervical Injury?

Upper Cervical Spine Model

A study 1 published in The Spine Journal shared interesting results about CT exams and detecting upper cervical spine injuries. The conclusion hoped the current study’s data might help with earlier detection of craniocervical dissociative injuries.

Why Conduct Such a Study?

Research shows that in fatal cervical spine injuries, the common findings are traumatic occipitocervical (or OC) injuries. These OC injuries include damage being done to the OC as well as AA (atlantoaxial) articulations.

The more traditional diagnostic methods for the evaluation of the human upper cervical spine made use of the relationship between the cervical spine and the skull. It used lateral radiographs for visualization. However, the said method tends to have limited sensitivity as well as specificity. That’s why CT (computed tomography) scans ended up being used more. But, even then, the parameters for identifying normal and abnormal CT anatomy (especially in the upper cervical spine) need more clarity.

The current study was conducted to offer details of the normal anatomical features as well as upper cervical spine relationships, as displayed on the CT scan. The goal was to establish better threshold measurements when it comes to detecting subtle cervical injury or abnormality.

The Method Used

The design of this study can be defined as a retrospective anatomical case review. This study’s patient population was 100. All of them had undergone a screening CT scan (multidirectional) of their cervical spine. The research team randomly selected patients by using the radiology teaching file as well as the trauma registry databases. All of the scans were deemed negative for trauma (focusing on the craniocervical junction).

A total of 76 cervical CT scans (thin-sliced) were randomly selected for this study. Take note; the team made 42 different anatomical measurements of the upper cervical spine.

What Did the Results Conclude?

The results showed the least variation in direct measurements. The mean OC joint space came in at 0.6 mm, with the AA joint space being 0.6 mm. Significantly higher standard deviation as well as variability was demonstrated by the midsagittal structures.

The current data was used to reach certain conclusions. There was no variance (according to demographics) when it came to the left-right symmetry and narrow joint spaces in the cervical spine joints. The consistency in the coronal plane was regarded as the factor enabling precise diagnostic measurements and comparisons. According to this study, such precision can help with accurately identifying abnormal scans.

A better understanding of upper cervical spine-centric relationships may help with earlier detection of subtle craniocervical dissociative injuries (dependent on the data from CT scans). A subtle misalignment could serve as evidence for a severe injury when looking at CT scans.


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