Abstract：
BACKGROUND: Clinical decision protocols for evaluation and assessment of traumatic cervical spine injuries (TCSI) lean more towards the use of CT imaging. Investigation with MRI is therefore considered unnecessary following negative CT findings according to some local protocols. This review aims to explore what benefits MRI may offer in the clinical management of TCSI patients.
METHODS: A systematic search of the literature was conducted in the following databases: AMED, CINAHL, EMBASE and MEDLINE using defined key terms and synonyms optimised for each database. The eligible articles were subjected to data extraction and thematic synthesis.
RESULTS: The initial electronic search yielded 2527 articles. Of these, 15 articles remained following the application of a pre-defined inclusion criteria and full-text assessment. Four themes (mechanism of injury, type of patient, injuries detected on MRI, significance of injuries detected on MRI) were developed relating to the usage and value of MRI in the management of CSI.
CONCLUSIONS: Our findings indicate that MRI may be very valuable in some situations for the evaluation of TCSI, however, its usage must be cautiously considered on a case-by-case basis in light of additional clinical benefit, patient safety and resource availability following a normal CT scan or in conjunction with CT or projection radiography where appropriate.
CONCLUSIONS: MRI may serve as a confirmatory test in the management pathway of TCSI based on individual clinical needs. Consideration for key limitations (e.g., patients\' cooperation) and accessibility challenges (e.g., cost) against the clinical benefit to the patient must be noted. Development of centre-specific policies from standard trauma imaging protocols may be essential for the timely management of TCSI.
METHODS: A systematic search of the literature was conducted in the following databases: AMED, CINAHL, EMBASE and MEDLINE using defined key terms and synonyms optimised for each database. The eligible articles were subjected to data extraction and thematic synthesis.
RESULTS: The initial electronic search yielded 2527 articles. Of these, 15 articles remained following the application of a pre-defined inclusion criteria and full-text assessment. Four themes (mechanism of injury, type of patient, injuries detected on MRI, significance of injuries detected on MRI) were developed relating to the usage and value of MRI in the management of CSI.
CONCLUSIONS: Our findings indicate that MRI may be very valuable in some situations for the evaluation of TCSI, however, its usage must be cautiously considered on a case-by-case basis in light of additional clinical benefit, patient safety and resource availability following a normal CT scan or in conjunction with CT or projection radiography where appropriate.
CONCLUSIONS: MRI may serve as a confirmatory test in the management pathway of TCSI based on individual clinical needs. Consideration for key limitations (e.g., patients\' cooperation) and accessibility challenges (e.g., cost) against the clinical benefit to the patient must be noted. Development of centre-specific policies from standard trauma imaging protocols may be essential for the timely management of TCSI.
摘要：
背景：评估和评估创伤性颈椎损伤（TCSI）的临床决策方案更倾向于使用CT成像。因此，根据某些局部协议，在CT阴性发现后，使用MRI进行调查被认为是不必要的。这篇综述旨在探讨MRI在TCSI患者的临床管理中可能提供的益处。
方法：在以下数据库中对文献进行了系统搜索：AMED，CINAHL,EMBASE和MEDLINE使用为每个数据库优化的定义的关键术语和同义词。对符合条件的文章进行了数据提取和专题综合。
结果：最初的电子搜索产生了2527篇文章。其中,在应用预定义的纳入标准和全文评估之后，仍然有15篇文章。四个主题(伤害机制，患者类型,MRI检测到的损伤,在MRI上检测到的损伤的意义）与MRI在CSI管理中的使用和价值有关。
结论：我们的研究结果表明，MRI在某些情况下对TCSI的评估可能非常有价值，然而,必须根据额外的临床益处，根据具体情况谨慎考虑其使用，正常CT扫描后或在适当情况下结合CT或投影射线照相术后的患者安全性和资源可用性。
结论：MRI可作为基于个体临床需要的TCSI管理途径的确证性检验。考虑关键限制(例如，患者合作)和无障碍挑战(例如，成本)必须注意对患者的临床益处。根据标准创伤成像协议制定针对特定中心的政策对于及时管理TCSI至关重要。
方法：在以下数据库中对文献进行了系统搜索：AMED，CINAHL,EMBASE和MEDLINE使用为每个数据库优化的定义的关键术语和同义词。对符合条件的文章进行了数据提取和专题综合。
结果：最初的电子搜索产生了2527篇文章。其中,在应用预定义的纳入标准和全文评估之后，仍然有15篇文章。四个主题(伤害机制，患者类型,MRI检测到的损伤,在MRI上检测到的损伤的意义）与MRI在CSI管理中的使用和价值有关。
结论：我们的研究结果表明，MRI在某些情况下对TCSI的评估可能非常有价值，然而,必须根据额外的临床益处，根据具体情况谨慎考虑其使用，正常CT扫描后或在适当情况下结合CT或投影射线照相术后的患者安全性和资源可用性。
结论：MRI可作为基于个体临床需要的TCSI管理途径的确证性检验。考虑关键限制(例如，患者合作)和无障碍挑战(例如，成本)必须注意对患者的临床益处。根据标准创伤成像协议制定针对特定中心的政策对于及时管理TCSI至关重要。
