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Nexus C-Spine

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https://www.readbyqxmd.com/read/27842904/yield-of-computed-tomography-of-the-cervical-spine-in-cases-of-simple-assault
#1
Matthew L Uriell, Jason W Allen, Brendan P Lovasik, Marc D Benayoun, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-impact, non-penetrating or "simple" assault at our institution and others. Common clinical decision tools for C-spine imaging in the setting of trauma include the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). While NEXUS and CCR have served to decrease the amount of unnecessary imaging of the C-spine, overutilization of CT is still of concern...
October 29, 2016: Injury
https://www.readbyqxmd.com/read/27454805/utility-of-computed-tomographic-imaging-of-the-cervical-spine-in-trauma-evaluation-of-ground-level-fall
#2
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27438681/cervical-spinal-clearance-a-prospective-western-trauma-association-multi-institutional-trial
#3
Kenji Inaba, Saskya Byerly, Lisa D Bush, Matthew J Martin, David T Martin, Kimberly A Peck, Galinos Barmparas, Matthew J Bradley, Joshua P Hazelton, Raul Coimbra, Asad J Choudhry, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Bellal Joseph, Julie Dunn, Christian T Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades
BACKGROUND: For blunt trauma patients who have failed the NEXUS (National Emergency X-Radiography Utilization Study) low-risk criteria, the adequacy of computed tomography (CT) as the definitive imaging modality for clearance remains controversial. The purpose of this study was to prospectively evaluate the accuracy of CT for the detection of clinically significant cervical spine (C-spine) injury. METHODS: This was a prospective multicenter observational study (September 2013 to March 2015) at 18 North American trauma centers...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27330655/prospective-validation-of-modified-nexus-cervical-spine-injury-criteria-in-low-risk-elderly-fall-patients
#4
John Tran, Donald Jeanmonod, Darin Agresti, Khalief Hamden, Rebecca K Jeanmonod
INTRODUCTION: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27032009/utility-of-computed-tomography-imaging-of-the-cervical-spine-in-trauma-evaluation-of-ground-level-fall
#5
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: CT of the cervical spine is routinely ordered for low-risk mechanisms of injury, including ground level fall (GLF). Two commonly employed clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I ED who received C-spine CT scans were obtained over a six month period...
March 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26827890/cervical-spine-evaluation-in-the-bluntly-injured-patient
#6
Tanya L Zakrison, Brian H Williams
BACKGROUND: Cervical spine injuries causing spinal cord trauma are rare in blunt trauma yet lead to devastating morbidity and mortality when they occur. There exists considerable debate in the literature about the best way for clinicians to proceed in ruling out cervical spine injuries in alert or obtunded blunt trauma patients. METHODS: We reviewed the current literature and practice management guidelines to generate clinical recommendations for the detection and clearance of cervical spine injuries in the blunt trauma patient...
September 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26764283/emergency-radiology-straightening-of-the-cervical-spine-in-mdct-after-trauma-a-sign-of-injury-or-normal-variant
#7
Ulrich Linsenmaier, Zsuszsanna Deak, Aina Krtakovska, Francesco Ruschi, Nora Kammer, Stefan Wirth, Maximilian Reiser, Lucas Geyer
OBJECTIVE: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding. METHODS: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients...
2016: British Journal of Radiology
https://www.readbyqxmd.com/read/26346048/femur-fractures-should-not-be-considered-distracting-injuries-for-cervical-spine-assessment
#8
Robert T Dahlquist, Peter E Fischer, Harsh Desai, Amelia Rogers, A Britton Christmas, Michael A Gibbs, Ronald F Sing
INTRODUCTION: The National Emergency X-Radiography Utilization Study (NEXUS) clinical decision rule is extremely sensitive for clearance of cervical spine (C-spine) injury in blunt trauma patients with distracting injuries. OBJECTIVES: We sought to determine whether the NEXUS criteria would maintain sensitivity for blunt trauma patients when femur fractures were not considered a distracting injury and an absolute indication for diagnostic imaging. METHODS: We retrospectively analyzed blunt trauma patients with at least 1 femur fracture who presented to our emergency department as trauma activations from 2009 to 2011 and underwent C-spine injury evaluation...
December 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25710414/prospective-derivation-of-a-clinical-decision-rule-for-thoracolumbar-spine-evaluation-after-blunt-trauma-an-american-association-for-the-surgery-of-trauma-multi-institutional-trials-group-study
#9
MULTICENTER STUDY
Kenji Inaba, Lauren Nosanov, Jay Menaker, Patrick Bosarge, Lashonda Williams, David Turay, Riad Cachecho, Marc de Moya, Marko Bukur, Jordan Carl, Leslie Kobayashi, Stephen Kaminski, Alec Beekley, Mario Gomez, Dimitra Skiada
BACKGROUND: Unlike the cervical spine (C-spine), where National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rules can be used, evidence-based thoracolumbar spine (TL-spine) clearance guidelines do not exist. The aim of this study was to develop a clinical decision rule for evaluating the TL-spine after injury. METHODS: Adult (≥15 years) blunt trauma patients were prospectively enrolled at 13 US trauma centers (January 2012 to January 2014)...
March 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25085950/unstable-c-spine-injury-with-normal-c-spine-radiographs
#10
Mohammed Adris Razaq, Terasa Broom
There is some controversy surrounding the optimal mode of imaging in trauma patients with suspected cervical (C) spine injury. Various rules (most notably the Canadian C-spine rules and the NEXUS rules) have been designed to help reduce the need for imaging given the poor yield. Some authorities advocate CT for almost all cases whereas others advocate three view radiographs unless the patient is at high risk, in which case CT is the preferred choice. One meta-analysis showed sensitivity of 58% (39-76%) for plain radiographs and 98% for CT in identification of C-spine injuries following blunt trauma...
August 1, 2014: BMJ Case Reports
https://www.readbyqxmd.com/read/24896742/spine-and-sport
#11
REVIEW
Milko C de Jonge, Josef Kramer
The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are much more common compared to acute injuries. Chronic injuries to the spine most often occur in low-contact sports like gymnastics and are most commonly the result of overuse. Acute injuries are more common in high-speed and full contact sports and are traumatic in origin. Injuries to the spinal cord can be devastating but are fortunately very uncommon. Although imaging of the spine appears to be straightforward, any radiologist will acknowledge that the optimal imaging strategy is often unclear due to several reasons...
July 2014: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/24506638/igrt-art-phantom-with-programmable-independent-rib-cage-and-tumor-motion
#12
Olivier C L Haas, John A Mills, Imke Land, Pete Mulholl, Paul Menary, Robert Crichton, Adrian Wilson, John Sage, Morenc Anna, Tom Depuydt
PURPOSE: This paper describes the design and experimental evaluation of the Methods and Advanced Equipment for Simulation and Treatment in Radiation Oncology (MAESTRO) thorax phantom, a new anthropomorphic moving ribcage combined with a 3D tumor positioning system to move target inserts within static lungs. METHODS: The new rib cage design is described and its motion is evaluated using Vicon Nexus, a commercial 3D motion tracking system. CT studies at inhale and exhale position are used to study the effect of rib motion and tissue equivalence...
February 2014: Medical Physics
https://www.readbyqxmd.com/read/24480220/evaluation-of-cervical-spine-fracture-in-the-elderly-can-we-trust-our-physical-examination
#13
COMPARATIVE STUDY
Terral Goode, Andrew Young, Sean P Wilson, Judith Katzen, Luke G Wolfe, Therese M Duane
The purpose of this trial was to compare National Emergency X-Radiography Utilization Study (NEXUS) criteria (NC) with computed tomography (CT) as the gold standard to evaluate cervical spine (C-spine) fractures in elderly blunt trauma patients. We prospectively compared adult blunt trauma patients 65 years or older (E) with younger than 65 years (NE), evaluating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of NC compared with CT in these two cohorts. A total of 2785 blunt trauma patients were included of whom 320 were E (average age, 75 years) and 2465 were NE (average age, 36 years)...
February 2014: American Surgeon
https://www.readbyqxmd.com/read/24094866/imaging-in-the-nexus-negative-patient-when-we-break-the-rule
#14
John Morrison, Rebecca Jeanmonod
BACKGROUND: In spite of general acceptance and validation of NEXUS (National Emergency X-Radiography Utilization Study) in the clearance of cervical spine (C-spine) immobilized patients, clinicians often elect to image NEXUS-negative patients in clinical practice. OBJECTIVES: We sought to determine which variables (patient age, mechanism of injury, provider level of training, provider self-reported motivation) contribute to the decision of emergency medicine providers to image NEXUS-negative patients...
January 2014: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/23511130/ct-for-all-or-selective-approach-who-really-needs-a-cervical-spine-ct-after-blunt-trauma
#15
Therèse M Duane, Andrew Young, Julie Mayglothling, Sean P Wilson, William F Weber, Luke G Wolfe, Rao R Ivatury
BACKGROUND: Computed tomography (CT) is the standard to screen blunt trauma patients for cervical spine (c-spine) fractures, yet there remains a reluctance to scan all trauma team activations because of radiation exposure and cost. The purpose of this study was to identify predictors of positive CT in an effort to decrease future CT use without compromising patient care. METHODS: We performed a prospective study in which we documented 18 combined NEXUS and Canadian c-spine criteria on 5,182 patients before CT comparing those with and without fractures to identify predictors of injury...
April 2013: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/23048086/accuracy-of-the-canadian-c-spine-rule-and-nexus-to-screen-for-clinically-important-cervical-spine-injury-in-patients-following-blunt-trauma-a-systematic-review
#16
REVIEW
Zoe A Michaleff, Chris G Maher, Arianne P Verhagen, Trudy Rebbeck, Chung-Wei Christine Lin
BACKGROUND: There is uncertainty about the optimal approach to screen for clinically important cervical spine (C-spine) injury following blunt trauma. We conducted a systematic review to investigate the diagnostic accuracy of the Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS) criteria, 2 rules that are available to assist emergency physicians to assess the need for cervical spine imaging. METHODS: We identified studies by an electronic search of CINAHL, Embase and MEDLINE...
November 6, 2012: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/23042928/screening-cervical-spine-ct-in-the-emergency-department-phase-2-a-prospective-assessment-of-use
#17
B Griffith, M Kelly, P Vallee, M Slezak, J Nagarwala, S Krupp, C P Loeckner, L R Schultz, R Jain
BACKGROUND AND PURPOSE: The National Emergency X-Radiography Utilization Study Low-Risk Criteria were established to identify patients with a low probability of cervical spine injury in whom imaging of the cervical spine was unnecessary. The purpose of this study was to ascertain the number of unnecessary cervical spine CT studies on the basis of proper application of established clinical guidelines and, secondarily, to determine indications for ordering studies in the absence of guideline criteria...
April 2013: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/22228252/the-nexus-criteria-do-they-stand-the-test-of-time
#18
Niamh C Collins, Juliet V McKenzie
The National Emergency X-ray Utilisation Study (NEXUS) criteria and the Canadian cervical spine rules are validated clinical decision-making tools used to facilitate selective cervical spine (C-spine) radiography. The NEXUS criteria are frequently used, as the Canadian cervical spine rules have been noted to be difficult to learn, remember and implement. We present a series of significant C-spine injury in three elderly patients who would not have warranted C-spine imaging using the NEXUS criteria. Each patient was mobile and fully orientated after the injury...
February 2013: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/21324290/using-cervical-spine-clearance-guidelines-in-a-pediatric-population-a-survey-of-physician-practices-and-opinions
#19
Emma C Burns, Natalie L Yanchar
BACKGROUND: Unlike in adults, there are currently no standardized, validated guidelines to aid practitioners in clearing the pediatric cervical spine (C-spine). Many pediatric centres in Canada have locally produced, adult-modified guidelines, but the extent to which these or other guidelines are used is unknown. OBJECTIVE: The purpose of this study was to determine if Canadian physicians are using either locally produced or adult C-spine guidelines to clear the C- spines of patients < 16 years of age...
January 2011: CJEM
https://www.readbyqxmd.com/read/20016389/frequent-computed-tomography-scanning-due-to-incomplete-three-view-x-ray-imaging-of-the-cervical-spine
#20
Teun Peter Saltzherr, Ludo F M Beenen, Johannes B Reitsma, Jan S K Luitse, W Peter Vandertop, J Carel Goslings
BACKGROUND: Conventional C-spine imaging (3-view series) is still widely used in trauma patients, although the utilization of computed tomography (CT) scanning is increasing. The aim of this study was to analyze the value of conventional radiography and the frequency of subsequent CT scanning due to incompleteness of three-view series of the C-spine in adult blunt trauma patients. METHODS: We analyzed the data of a prospectively collected database including all patients between November 2005 and November 2007 treated in the trauma resuscitating room...
May 2010: Journal of Trauma
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