Prevertebral soft-tissue measurements in cervical spine injury.

To clarify normal values for cervical prevertebral soft-tissue measurements and evaluate when they are useful as a marker of cervical spine injury, the prevertebral soft-tissue measurements of 79 control and 57 acutely injured patients were retrospectively compared by two independent observers. The second, blinded, observer made a provisional diagnosis and indicated if increased soft-tissue measurements had assisted in making a diagnosis of injury. If measurements > 7 mm at C2/3 and > 21 mm at C6/7 were considered abnormal, a true positive rate of 53% and false positive rate of 5% were observed. The differences between the mean measurements in the control and injured groups were statistically significant (P < 0.0001 at C2/3 and P < 0.01 at C6). Soft-tissue measurement improved the diagnostic confidence of the blinded second reviewer in 17.5% of the injured group. Analysis of this subgroup revealed a 50% error rate in initial reporting. In all of these cases, the abnormal soft-tissues had been ignored prospectively Routine measurement of the prevertebral soft tissues is a simple procedure that may provide an important due to subtle cervical spine injury.

[1]  D. Debehnke,et al.  Utility of prevertebral soft tissue measurements in identifying patients with cervical spine fractures. , 1994, Annals of emergency medicine.

[2]  B. Tress,et al.  Prevertebral swelling in cervical spine injury: identification of ligament injury with magnetic resonance imaging. , 1992, Clinical radiology.

[3]  R. Daffner.  Evaluation of cervical vertebral injuries. , 1992, Seminars in roentgenology.

[4]  D. Myssiorek,et al.  Traumatic retropharyngeal hematoma. , 1989, Archives of otolaryngology--head & neck surgery.

[5]  G. El-Khoury,et al.  Radiographic Evaluation of Cervical Spine Injuries , 1988, Spine.

[6]  P. Driscoll,et al.  Accuracy of detection of radiographic abnormalities by junior doctors. , 1988, Archives of emergency medicine.

[7]  K. Miles,et al.  Is prevertebral soft tissue swelling a useful sign in injury of the cervical spine? , 1988, Injury.

[8]  N. Mcswain,et al.  Factors affecting the cervical prevertebral space in the trauma patient. , 1988, The American journal of emergency medicine.

[9]  D. Reid,et al.  Etiology and clinical course of missed spine fractures. , 1987, The Journal of trauma.

[10]  K. Gopalakrishnan,et al.  Prevertebral soft tissue shadow widening--an important sign of cervical spinal injury. , 1986, Injury.

[11]  C. S. Petty,et al.  Occult cervical spine injuries in fatal traffic accidents. , 1979, The Journal of trauma.

[12]  R Robinson,et al.  The pathological findings in fatal craniospinal injuries. , 1971, Journal of neurosurgery.

[13]  J. Whalen,et al.  The cervical prevertebral fat stripe. A new aid in evaluating the cervical prevertebral soft tissue space. , 1970, The American journal of roentgenology, radium therapy, and nuclear medicine.

[14]  C. L. Oon.  SOME SAGITTAL MEASUREMENTS OF THE NECK IN NORMAL ADULTS. , 1964, The British journal of radiology.

[15]  M. Wholey,et al.  The Lateral Roentgenogram of the Neck , 1958 .

[16]  M. Kathol,et al.  Imaging of acute injuries of the cervical spine: value of plain radiography, CT, and MR imaging. , 1995, AJR. American journal of roentgenology.

[17]  J. Harrisjr.  Abnormal cervicocranial retropharyngeal soft-tissue contour in the detection of subtle acute cervicocranial injuries , 1994 .

[18]  W. Smoker,et al.  Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging. , 1990, Radiology.

[19]  L. Wagner,et al.  Hyperextension dislocation of the cervical spine. , 1986, AJR. American journal of roentgenology.

[20]  T. Paakkala.  Prevertebral soft tissue changes in cervical spine injury. , 1985, Critical reviews in diagnostic imaging.

[21]  D. C. Weir,et al.  Roentgenographic signs of cervical injury. , 1975, Clinical orthopaedics and related research.