MRI Is the New Gold Standard for Excluding Cervical Spine Injury in Patients With Blunt Trauma

George D. Lundberg, MD

Cervical spine injury can have very serious consequences and can be difficult to diagnose. Five investigators in Wisconsin with a meta-analysis selected 5 prospective or retrospective published diagnostic protocol results that included magnetic resonance imaging. They studied reports of 464 victims of blunt trauma with clinically suspicious or unevaluatable cervical spines. Clinical follow-up was the gold standard. Sensitivity of MRI for cervical spine abnormalities was 97%, with a negative predictive value of 100% and zero false negatives; specificity was 99% with a positive predictive value of 94%; 97 patients, that is, 21%, had abnormalities by MRI that were not found by radiographs or CT. This study, reported in 2008 in The Journal of Trauma,[1] establishes MRI as the new gold standard for conclusively excluding cervical spine injury in a patient with blunt trauma.