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Cervical Spine CT Scan Not Needed for Ground Level Falls and Simple Assault Patients

By MedImaging International staff writers
Posted on 23 May 2012

Cervical spine CT scans have been deemed to be unnecessary for emergency department (ED) patients who are a victim of “simple assault” or who have a “ground-level fall,” unless the patient has a condition that predisposes the patient to spine fracture.

The study, conducted at Grady Memorial Hospital (Atlanta, GA, USA) by researchers from the department of radiology and imaging sciences of the Emory University School of Medicine (Atlanta, GA, USA), found that out of 218 exams for simple assault, there were none that were positive, said Andrew Nicholson, MD, lead author of the study. In the series of 154 cervical spine CT scans that were obtained for ground-level fall, there was only one positive exam. This fracture was in a patient with ankylosing spondylitis, a condition that is known to increase the risk of fracture of the spine.

“The criteria that exist for cervical spine imaging can be vague in certain circumstances and lead to many patients receiving this exam who likely don’t need it,” said Dr. Nicholson. “At our level-1 trauma center in the past 12 months, there were 5,046 cervical spine CT examinations; in 2003, there were 2,091, an increase of 241%,” he said.

“While this study looks at a relatively small subset of the CT exams ordered from the ED, we believe it can have a significant impact on radiation dose reduction at a population level,” said Chad Holder, MD, senior author of the study. “These patients frequently have CT scans of the head and/or the face at the same time. The radiation dose to the lenses of the eyes, thyroid, and lymph nodes from cervical spine CT is not insignificant; reducing unnecessary radiation exposure to these organs is important.”

“Additionally, overutilization of high-cost imaging exams has contributed to the increase in healthcare expenditures. Efforts to contain these two aspects should be led by radiologists, who can be a driving force to reduce overutilization,” said Dr. Nicholson.

The study was presented May 7, 2012, at the American Roentgen Ray Society annual meeting in Vancouver (BC, Canada).

Related Links:
Grady Memorial Hospital
Emory University School of Medicine

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68 (72.002410888672): SELECT fid FROM jos_deeppockets WHERE id=294740745 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294740745 AND published='1' LIMIT 1

69 (47.922134399414): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (580.0724029541): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (421.04721069336): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (73.909759521484): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (!!!!! 1005.8879852295): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (184.05914306641): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (65.803527832031): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (171.18453979492): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 1258.8500976562): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (64.849853515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (56.028366088867): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (82.969665527344): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (67.949295043945): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (47.922134399414): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (138.0443572998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

105 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

106 (69.856643676758): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (796.07963562012): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3151.8936157227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

109 (166.89300537109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

110 (84.877014160156): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (782.01293945312): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (703.09638977051): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (514.98413085938): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

115 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

116 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

117 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

118 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

119 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

120 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

121 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

122 (350.9521484375): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 58851.003646851): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (813.00735473633): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740745 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740745 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 19189.119338989): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (106.8115234375): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (93.936920166016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (236.03439331055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (112.05673217773): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (87.02278137207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (558.13789367676): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (56.028366088867): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (63.896179199219): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (51.021575927734): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1072.1683502197): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 3931.0455322266): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (488.9965057373): SELECT name FROM jos_deeppockets WHERE id=211

138 (59.843063354492): SELECT name FROM jos_deeppockets WHERE id=211

139 (931.97822570801): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (709.05685424805): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (588.17863464355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

142 (223.15979003906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

143 (!!!!! 12567.99697876): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 8363.9621734619): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (303.98368835449): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294740745 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1308.2027435303): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (327.11029052734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 4454.1358947754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

149 (292.06275939941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

150 (!!!!! 4579.0672302246): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (!!!!! 7858.9916229248): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

152 (!!!!! 4975.0804901123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

153 (94.890594482422): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740745 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740745 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 1960.0391387939): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (249.14741516113): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (627.04086303711): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 2171.0395812988): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

158 (!!!!! 1781.9404602051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740745 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740745 AND published='1' LIMIT 1

159 (878.09562683105): select jos_twitters.link from jos_twitters where cat=10

160 (335.9317779541): select jos_facebook.link from jos_facebook where cat=10

161 (49.114227294922): select jos_google_plus.link from jos_google_plus where cat=10

162 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

163 (!!!!! 3092.0505523682): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1578.0925750732): insert into jos_banners_delta values (14615,'2025-08-19 19:38:51','216.73.216.0','view'),(14202,'2025-08-19 19:38:51','216.73.216.0','view'),(14203,'2025-08-19 19:38:51','216.73.216.0','view')

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