Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I XXXX center.

@entity1 @entity64 @entity174 @entity6746 @entity3627 @entity1317 @entity130
UNASSIGNED: OBJECT Screening for @entity1317 ( @entity1317 ) following cervical spine fractures is routinely performed across @entity130 centers in North America. From 2002 to 2007, the total number of neck CT angiography (CTA) studies performed in the Medicare population after @entity130 increased from 9796 to 115,021. In the era of cost-effective medical care, the authors aimed to evaluate the utility of CTA screening in detecting @entity1317 and reduce chances of posterior circulation @entity64 after traumatic cervical spine fractures. METHODS A retrospective review of all @entity1 presenting with cervical spine fractures to Northeast Ohio's Level I @entity130 institution from 2002 to 2012 was performed. RESULTS There was a total of 1717 cervical spine fractures in @entity1 presenting to Northeast Ohio's Level I @entity130 institution between 2002 and 2012. CTA screening was performed in 732 @entity1 , and 51 @entity1 (0.7%) were found to have a @entity1317 . @entity174 patterns with increased odds of @entity1317 were @entity6746 and @entity3627 combined fractures, @entity174 , and subluxation of adjacent vertebral levels. Ten posterior circulation @entity64 were identified in this @entity1 population (0.6%) and found in only 4 of 51 cases of @entity1317 (7.8%). High-risk fractures defined by Denver Criteria, @entity1317 , and antiplatelet treatment of @entity1317 were not independent predictors of @entity64 . CONCLUSIONS Cost-effective screening must be reevaluated in the setting of blunt cervical spine fractures on a case-by-case basis. Further prospective studies must be performed to elucidate the utility of screening for @entity1317 and posterior circulation @entity64 prevention, if identified.
