Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 1 - COMPONENTS OF IDEAL SCI CARE SYSTEM

D - DIAGNOSTIC IMAGING




In the obtunded or unevaluable patient, high-quality CT imaging, if available, is recommended as the initial imaging modality of choice. (Adapted from CNS-RADIO 2013, p.54; Level A)
We recommend clinicians conduct a 3-view cervical spine series (anteroposterior, lateral, and odontoid views) if high-quality CT imaging is not available. We recommend supplementing the imaging with CT (when available) to further define areas that are suspicious or not well visualized on the plain cervical x-rays. (CNS-RADIO 2013, p.54; Level A)

In the obtunded or unevaluable patient with a normal high-quality CT or normal 3-view cervical spine series, the following recommendations should be considered:

  1. continue cervical immobilization until asymptomatic
  2. discontinue cervical immobilization following a normal MRI study obtained within 48 hours of injury (limited and conflicting Class II and Class III medical evidence), or
  3. discontinue cervical immobilization at the discretion of the treating physician.
(CNS-RADIO 2013, p.54; Level C)
In the obtunded or unevaluable patient with a normal high-quality CT, the routine use of dynamic imaging appears to be of marginal benefit and is not recommended. (CNS-RADIO 2013, p.54; Level C)