Evaluation of the thoracic and lumbar spine after blunt XXXX .

@entity1 @entity174 @entity130
BACKGROUND: Routine performance of thoraco-lumbar (TL) spinal radiology in @entity1 with blunt @entity130 is controversial. @entity1 AND METHODS: To establish indications for radiologic screening of the TL spine, a retrospective review of 344 @entity1 who had radiologic evaluation of the spine was performed. RESULTS: Forty-seven @entity1 had abnormalities detected on radiologic evaluation. One hundred eighty-six @entity1 had at least one clinical finding suggestive of injury. Thirty-two had abnormal radiographs. Thirteen of these abnormalities represented old or minor @entity174 and were not treated. Nineteen @entity1 had injuries requiring treatment. Two @entity1 were treated with activity restriction, 12 with a back brace, 4 with operative fixation, and 1 @entity1 died prior to operation. Of the 129 @entity1 who were awake, alert, and without clinical evidence of injury, 10 had abnormal radiologic studies. Three @entity1 had old @entity174 , 4 had transverse process @entity174 , and 3 had spondylolisthesis. None of these @entity1 required treatment. Twenty-nine @entity1 had equivocal clinical examinations primarily due to altered levels of consciousness. Five @entity1 had abnormal radiologic studies, 3 of whom required treatment. Three factors associated with the occurrence of TL spine injury were identified: an Injury Severity Score > or = 15, a positive clinical examination, and a fall of > or = 10 feet. CONCLUSIONS: These data suggest that @entity1 who are awake, alert, and with no clinical evidence of injury do not require radiologic study of the TL spine. @entity1 with equivocal or positive clinical findings or with altered levels of consciousness should have complete TL spine evaluation.
