Cervical spine trauma - Evaluating the diagnostic power of CT, MRI, X-Ray and LODOX.BACKGROUND
 Traumatic cervical spine (c-spine) injuries account for 10% of all spinal injuries.  The c-spine is prone to injury by blunt acceleration/deceleration traumas.  The Canadian C-Spine rule and NEXUS criteria guide clinical decision-making but lack consensus on imaging modality when necessary.  This study aims to evaluate the sensitivity and specificity of CT, MRI, X-Ray, and, for the first time, LODOX-Statscan in identifying c-spine injuries in patients with blunt trauma and neck pain.


 We conducted a retrospective monocenter cohort study using patient data from the emergency department at Inselspital, Bern, Switzerland's largest level one trauma center.  We identified patients presenting with trauma and neck pain during the recruitment period from 01.01.2012 to 31.12.2017.  We included all patients that required a radiographic c-spine evaluation according to the NEXUS criteria.  Certified spine surgeons reviewed each case, analyzed patient demographics, injury classification, trauma mechanism, and emergency management.  The retrospective full case review was established as gold standard to decide whether the c-spine was injured.  Sensitivity and specificity were calculated for CT, MRI, LODOX, and X-Ray imaging methods.


 We identified 4996 patients, of which 2321 met the inclusion criteria.  91.3% (n = 2120) patients received a CT scan, 8.9% (n = 206) a MRI, 9.3% (n = 215) an X-ray, and 21.5% (n = 498) a LODOX scan.  By retrospective case review, 186 participants were classified as injured.  The sensitivity of CT was 88.6% (specificity 99%), and 89.8% (specificity 99.2%) with orthopedic surgeon consultation.  MRI had a sensitivity of 88.5% (specificity of 96.9%); highlighting 14 cases correctly diagnosed as injured by MRI and misdiagnosed by CT.  Projection radiography (36.4% sensitivity, 95.1% specificity) and LODOX (5.3% sensitivity, 100% specificity) were unsuitable for ruling out spinal injury.


 CONCLUSION
 While CT offers high sensitivity for detecting traumatic c-spine injury, MRI holds clinical significance in revealing injuries not recognized by CT in symptomatic patients.  LODOX and projection radiography are insufficient for accurately ruling out c-spine injury.  For patients with neurological symptoms, we recommend extended MRI use when CT scans are negative.
C
91.3% (n = 2120) patients received a CT scan, 8.9% (n = 206) a MRI, 9.3% (n = 215) an X-ray, and 21.5% (n = 498) a LODOX scan.  For patients with neurological symptoms, we recommend extended MRI use when CT scans are negative.
CT scan
Cervical spine trauma - Evaluating the diagnostic power of CT, MRI, X-Ray and LODOX.BACKGROUND
 This study aims to evaluate the sensitivity and specificity of CT, MRI, X-Ray, and, for the first time, LODOX-Statscan in identifying c-spine injuries in patients with blunt trauma and neck pain.


 Sensitivity and specificity were calculated for CT, MRI, LODOX, and X-Ray imaging methods.


 91.3% (n = 2120) patients received a CT scan, 8.9% (n = 206) a MRI, 9.3% (n = 215) an X-ray, and 21.5% (n = 498) a LODOX scan.  MRI had a sensitivity of 88.5% (specificity of 96.9%); highlighting 14 cases correctly diagnosed as injured by MRI and misdiagnosed by CT.  While CT offers high sensitivity for detecting traumatic c-spine injury, MRI holds clinical significance in revealing injuries not recognized by CT in symptomatic patients.  For patients with neurological symptoms, we recommend extended MRI use when CT scans are negative.
MRI
Cervical spine trauma - Evaluating the diagnostic power of CT, MRI, X-Ray and LODOX.BACKGROUND
 This study aims to evaluate the sensitivity and specificity of CT, MRI, X-Ray, and, for the first time, LODOX-Statscan in identifying c-spine injuries in patients with blunt trauma and neck pain.


 Sensitivity and specificity were calculated for CT, MRI, LODOX, and X-Ray imaging methods.


 91.3% (n = 2120) patients received a CT scan, 8.9% (n = 206) a MRI, 9.3% (n = 215) an X-ray, and 21.5% (n = 498) a LODOX scan. 
X-Ray
Cervical spine trauma - Evaluating the diagnostic power of CT, MRI, X-Ray and LODOX.BACKGROUND
 This study aims to evaluate the sensitivity and specificity of CT, MRI, X-Ray, and, for the first time, LODOX-Statscan in identifying c-spine injuries in patients with blunt trauma and neck pain.


 Sensitivity and specificity were calculated for CT, MRI, LODOX, and X-Ray imaging methods.


 91.3% (n = 2120) patients received a CT scan, 8.9% (n = 206) a MRI, 9.3% (n = 215) an X-ray, and 21.5% (n = 498) a LODOX scan.  Projection radiography (36.4% sensitivity, 95.1% specificity) and LODOX (5.3% sensitivity, 100% specificity) were unsuitable for ruling out spinal injury.


 LODOX and projection radiography are insufficient for accurately ruling out c-spine injury. 
LODOX