caa a22 4500 47584209X CHVBK 20180406123903.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s101400050008 doi (NATIONALLICENCE)springer-10.1007/s101400050008 Improving the imaging diagnosis of cervical spine injury in the very elderly: implications of the epidemiology of injury [Elektronische Daten] [F. A. Mann, W. S. Kubal, C. C. Blackmore] Purpose: To enumerate host and vector factors that affect each phase of cervical spine injury (CSI) among the elderly, and to attribute specific pathoanatomic characteristics of CSI to host and/or vector factors. Methods: Structured review of English literature references selected from MEDLINE keyword search using PUBMED and OVID search engines. Only articles addressing the role of "aging” or being "elderly” (using a variety of definitions) in CSI were included. The following information was abstracted: journal; year of publication; authors' specialty or departmental affiliation; study design; inclusion and exclusion criteria; year(s) of data collection; number of CSI vs. controls; summary findings, including rate estimates, obvious study weaknesses. Results: Seven of 13 articles were medical-record-based case series, most derived from institutional trauma registries. Four were population-based surveys. One was an assessment of Medicare claims data for all-cause trauma and one a review paper. Blunt-force CSI was most commonly related to domestic falls, then to vehicular-pedestrian collisions and finally to vehicular crashes. More than two-thirds of fractures involved CO-C3, especially in individuals with cervical spondylosis and/or osteoporosis. In 15 to 40 % of CO-C3 fractures there is a delay in diagnosis. An adult forme fruste of SCIWORA (spinal cord injury without radiographic abnormality) was a relatively common cause of central and anterior cord syndromes in the absence of observable fractures or dislocations. Conclusions: The epidemiology of CSI in elderly patients should inform triage and imaging decisions. Since most CSI diagnostic errors involve the upper cervical spine, additional attention to the radiographic anatomy of the craniocervical junction and diligent search for abnormalities in this region are warranted. American Society of Emergency Radiology, 2000 Key words Cervical spine - Cervical spine injury or fracture or dislocation - Spinal trauma - Outcome - Spondylosis - Spinal stenosis - Adult - Elderly - Adult over 65 years old nationallicence Mann F. A. Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle, Washington, USA, US aut Kubal W. S. Department of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA, US aut Blackmore C. C. Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Ave. Box 359728, Seattle, WA 98104-2499, USA e-mail: famann@u.washington.edu Tel.: Voice mail + 1-206-7318205/ secretarial pool + 1-206-7313561 Fax: + 1-2 06-7 31 85 60, US aut https://doi.org/10.1007/s101400050008 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s101400050008 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mann F. A. Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle, Washington, USA, US aut NATIONALLICENCE 700 1- Kubal W. S. Department of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA, US aut NATIONALLICENCE 700 1- Blackmore C. C. Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Ave. Box 359728, Seattle, WA 98104-2499, USA e-mail: famann@u.washington.edu Tel.: Voice mail + 1-206-7318205/ secretarial pool + 1-206-7313561 Fax: + 1-2 06-7 31 85 60, US aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer