29 - CT of the Spine

Summary

CT of the spine is becoming one of the most common studies in the modern ED. Typically, CT is more sensitive than plain film for many pathologies, less expensive and faster than MRI, and usually available at all hours of the day. With new multislice helical scanners in many EDs, it is possible to get a complete scan with multiple protocols in less than 15 min door to door. This has obvious advantages over taking multiple plain films of the head, neck, chest, spine, and abdomen. Although the fixed cost of a CT scan is more expensive, a single trip to CT may save time, decreasing nursing and technologists' costs over multiple plain films with multiple trips to radiology (1). More importantly, CT yields a faster and more accurate diagnosis, leading to increased patient safety and satisfaction.

CLINICAL INDICATIONS

Trauma is one of the most common presentations to the ED that indicates the use of spinal CT to rule out, confirm or further evaluate injury. There are very well-established protocols that should be followed before resorting to the use of imaging to evaluate injury in the trauma patient. The National Emergency X-Radiography Utilization Study was conducted to evaluate the need for radiographic images in trauma patients with suspected mechanisms of spinal injury (2).