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A 64-slice CT with reconstructions does not entirely rule out ligamentous injury leading to instability, but is a practical means of identifying the majority of C-spine injuries in obtunded patients. MR C-spine has frequent false-positives, limiting its usefulness. [citation needed] In these cases, a consultation with a Spine Surgery specialist ...
There are two main algorithms, the Canadian C-spine rule and NEXUS, which are used to decide who requires cervical spine imaging via CT scan [6] after blunt trauma, and who can be cleared without imaging. [4] The Canadian C-spine rule appears to have greater sensitivity and specificity (i.e. fewer false positives and false negatives). [17]
In order to prevent further injury, such people may have a collar placed by medical professionals until X-rays can be taken to determine if a cervical spine fracture exists. [5] Medical professionals will often use the NEXUS criteria and/or the Canadian C-spine rules to clear a cervical collar and determine the need for imaging.
This practice has come under review recently as incidence rates of unstable spinal trauma can be as low as 2% in immobilized patients. In clearing the cervical spine, Canadian studies have developed the Canadian C-Spine Rule (CCR) for physicians to decide who should receive radiological imaging. [9]
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A medical history and physical examination can be sufficient in clearing the cervical spine.Notable clinical prediction rules to determine which patients need medical imaging are Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS).
Barnes-Lentz's morning routine takes about 2 ½ hours. She starts with what she describes as an "oral protocol," which includes tongue scraping, water flossing, and oil pulling. Tongue scraping ...
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