ACR Appropriateness Criteria® Suspected Spine Trauma.

Journal Article (Journal Article)

Injuries to the cervical and thoracolumbar spine are commonly encountered in trauma patients presenting for treatment. Cervical spine injuries occur in 3% to 4% and thoracolumbar fractures in 4% to 7% of blunt trauma patients presenting to the emergency department. Clear, validated criteria exist for screening the cervical spine in blunt trauma. Screening criteria for cervical vascular injury and thoracolumbar spine injury have less validation and widespread acceptance compared with cervical spine screening. No validated criteria exist for screening of neurologic injuries in the setting of spine trauma. CT is preferred to radiographs for initial assessment of spine trauma. CT angiography and MR angiography are both acceptable in assessment for cervical vascular injury. MRI is preferred to CT myelography for assessing neurologic injury in the setting of spine trauma. MRI is usually appropriate when there is concern for ligament injury or in screening obtunded patients for cervical spine instability. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Full Text

Duke Authors

Cited Authors

  • Expert Panel on Neurological Imaging and Musculoskeletal Imaging:, ; Beckmann, NM; West, OC; Nunez, D; Kirsch, CFE; Aulino, JM; Broder, JS; Cassidy, RC; Czuczman, GJ; Demertzis, JL; Johnson, MM; Motamedi, K; Reitman, C; Shah, LM; Than, K; Ying-Kou Yung, E; Beaman, FD; Kransdorf, MJ; Bykowski, J

Published Date

  • May 2019

Published In

Volume / Issue

  • 16 / 5S

Start / End Page

  • S264 - S285

PubMed ID

  • 31054754

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2019.02.002


  • eng

Conference Location

  • United States