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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.
However, the cervical spine is comparatively mobile, and some component of this movement is due to flexion and extension of the vertebral column itself. This movement between the atlas and occipital bone is often referred to as the "yes joint", owing to its nature of being able to move the head in an up-and-down fashion.
In a study from Norway the most common cause was falls and the relative incidence of cervical spine fracture increased significantly with age. [ 1 ] Sports that involve violent physical contact carry a risk of cervical fracture, including American football , association football (especially the goalkeeper ), ice hockey , rugby , and wrestling .
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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). [4] The AO Foundation has developed a descriptive system for cervical fractures, the AOSpine subaxial cervical spine fracture classification system. [5]
Little medical progress was made during the Middle Ages in Europe; it was not until the Renaissance that the spine and nerves were accurately depicted in human anatomy drawings by Leonardo da Vinci and Andreas Vesalius. [154] In 1762, Andre Louis, a surgeon, removed a bullet from the lumbar spine of a patient, who regained motion in the legs. [154]