Imaging Update on Cervical Spinal Trauma, Instability Screening, and Clearance

Clinicians from varied specialties rely on cervical spine imaging techniques. The assessment of cervical spine instability after trauma is one typical scenario where imaging is a critical part of the evaluation. Screening for instability in nontraumatic clinical scenarios is also germane, however. Protocols to guide the clinician as to what imaging study is most useful to assess each patient circumstance have been refined in the past decade. This development has been driven, in part, by an evolution in modern imaging techniques. Changes in guidelines have also been motivated by the outcomes of large prospective series evaluating screening techniques. While various guidelines have been proposed by clinicians with varied perspectives and specialties, the recommendations are converging and have become remarkably similar to one another. As such, practical protocols for evaluating cervical spinal trauma, instability, and clearance can be proposed with expectation for wide applicability and good predictability.

Keywords: cervical imaging, trauma clearance, instability evaluation, screening utility of flexion–extension radiographs, cervical screening guidelines