CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?
Journal
Global Spine Journal
ISSN
2192-5682
2192-5690
Date Issued
2021
Author(s)
Juan P. Cabrera
Andrei F. Joaquim
Alfredo Guiroy
Charles A. Carazzo
Marcelo Valacco
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Cross-sectional survey. </jats:p></jats:sec><jats:sec><jats:title>Objectives:</jats:title><jats:p> Assessment of subaxial cervical facet injuries using the AO Spine Subaxial Cervical Spine Injury Classification System is based on CT scan findings. However, additional radiological evaluations are not directly considered. The aim of this study is to determine situations in which spine surgeons request additional radiological exams after a facet fracture. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A survey was sent to AO Spine members from Latin America. The evaluation considered demographic variables, routine use of the Classification, as well as the timepoint at which surgeons requested a cervical MRI, a vascular study, and/ or dynamic radiographs before treatment of facet fractures. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> There was 229 participants, mean age 42.9 ± 10.2 years; 93.4% were men. Orthopedic surgeons 57.6% with 10.7 ± 8.7 years of experience in spine surgery. A total of 86% used the Classification in daily practice. An additional study (MRI/vascular study/and dynamic radiographs) was requested in 53.3%/9.6%/43.7% in F1 facet injuries; 76.0%/20.1%/50.2% in F2; 89.1%/65.1%/28.4% in F3; and 94.8%/66.4%/16.6% in F4. An additional study was frequently required: F1 72.5%, F2 86.9%, F3 94.7%, and F4 96.1%. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> Spine surgeons generally requested additional radiological evaluations in facet injuries, and MRI was the most common. Dynamic radiographs had a higher prevalence for F1/F2 fractures; vascular studies were more common for F3/F4 especially among surgeons with fewer years of experience. Private hospitals had a lower spine trauma cases/year and requested more MRI and more dynamic radiographs in F1/F2. Neurosurgeons had more vascular studies and dynamic radiographs than orthopedic surgeons in all facet fractures. </jats:p></jats:sec>
Subjects
spinal injuries
;
magnetic resonance imaging
;
tomography
;
radiography
;
facet joint
;
spine
;
vertebral artery
;
adult
;
article
;
cervical spine
;
cervical spine injury
;
clinical assessment
;
computer assisted tomography
;
cross-sectional study
;
daily life activity
;
decision making
;
degenerative disease
;
demography
;
female
;
human
;
lumbar spine
;
major clinical study
;
male
;
nuclear magnetic resonance imaging
;
orthopedic surgeon
;
posterior lumbar interbody fusion
;
prevalence
;
private hospital
;
questionnaire
;
south and central america
;
spine injury
;
spine surgery
;
x-ray computed tomography