Who needs radiographic evaluation of the cervical spine?
Patients who present to the emergency department with obvious signs of cord injury require evaluation of their cervical spine to precisely define the extent of the bony deformity and to plan specific treatment. Patients with an altered level of consciousness, regardless of the cause, require cervical radiographic evaluation. Controversy persists regarding the x-ray evaluation of the asymptomatic patient to exclude the “occult” cervical spine fracture. Many reports, a large number of them anecdotical, suggest the possibility of cervical spine injury in patient with no symptoms referable to the neck. 15-23 Careful analysis of these isolated reports employing the template described below fails to corroborate the conclusion that the truly occult cervical spine fracture exists. Extensive retrospective and prospective evidence supports the position that: l)alert patients, not under the influence of drugs or alcohol, 2)who have no complaints of neck pain or tenderness on palpation of the cerv
