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Prospective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma: An American Association for the Surgery of Trauma Multi-Institutional Trials Group Study.
J Trauma Acute Care Surg
March 2015
From the Division of Trauma and Surgical Critical Care, University of Southern California (K.I., L.N., D.S.) Los Angeles; Department of Surgery, Loma Linda University (D.T.), Loma Linda; Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, University of California San Diego (L.K.), La Jolla; and Trauma Service, Santa Barbara Cottage Hospital (S.K.), Santa Barbara, California; Department of Surgery, R Adams Cowley Shock Trauma Center (J.M.), University of Maryland School of Medicine, Baltimore, Maryland; Division of Trauma, Burns and Surgical Critical Care, University of Alabama at Birmingham (P.B.), Birmingham, Alabama; Department of Trauma, East Texas Medical Center (L.W.), Tyler; and Department of Surgery, University of Texas Southwestern-Austin (J.C.), Austin, Texas; Department of Surgery, Crozer-Chester Medical Center (R.C.), Upland; and Division of Acute Care Surgery, Thomas Jefferson University (A.B.), Philadelphia, Pennsylvania; Division of Trauma, Massachusetts General Hospital (M.D.), Harvard Medical School, Boston, Massachusetts; Broward General Medical Center (M.B.), Florida International University, Miami, Florida; and Division of Trauma and Surgical Critical Care, Lutheran Medical Center (M.G.), Brooklyn, New York.
Background: Unlike the cervical spine (C-spine), where National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rules can be used, evidence-based thoracolumbar spine (TL-spine) clearance guidelines do not exist. The aim of this study was to develop a clinical decision rule for evaluating the TL-spine after injury.
Methods: Adult (≥15 years) blunt trauma patients were prospectively enrolled at 13 US trauma centers (January 2012 to January 2014).