경추손상이 의심되는 환자에서 경추전방 연부조직 폭 측정의 의의 = THE VALUE OF THE MEASUREMENT OF PREVERTEBRAL SOFT TISSUE WIDTH IN PATIENTS WITH SUSPICIOUS OF CERVICAL SPINE INJURY

다국어 초록 (Multilingual Abstract)

Prevertebral soft tissue swelling of cervical spine lateral radiogram is well known as an indirect evidence of occult cervical spine injury. But the clinical and statistical value of it has been of debate. We tried to analyse the value of cervical prevertebral soft tissue width as a screening test for cervical spine injury by comparison of two categorized study groups; the control group, traumatized patients without cervical spine injury and the injury and the injury group, traumatized patients with bony cervical injury.
The injury group consisted of patients admitted between September 1993 and December 1994 with an ED diagnosis of bony cervical injury. The control group consisted of patients admitted between January 1994 and June 1994 who received cervical spine lateral radiograph because of suspicion of cervical spine injury or as a routine check. In both group, we sampled the patients who received cervical spine lateral rediograph within 24 hours after injury and excluded the patients less than 15 years old and more than 65 years old, In the control group, we confirmed the patients had no problem in cervical spine of follow-up. 101 control patients and 68 injury patients were identified. The injury group was further divided into two subgroups: those with injuries at C1-C3 to the upper injury subgroup and those with injuries at C4-C7 to the lower injury sub group.
The prevertebral soft tissue widths of injury group were larger than of control group at C2(mean 6.1mm versus 4.5mm) and also at C6(mean 13.4mm versus 11.2mm). Especially upper injury subgroup had quite large value of C2 prevertebral soft tissue width(mean 14.1mm). Nevertheless, both in C2 and C6, there is no cutoff value with acceptable sensitivity and specificity as a screening test. But the 7mm at C2 and 14mm at C6 had high specificity(90%) and were thought to be a good radiologic indicators of further evaluation.