Is Old Age a Reason to Scan a Cervical Spine?
/Radmard M, Tafazolimoghadam A, Hoseinyazdi M, et al. Is older age an appropriate criterion alone for ordering cervical spine computed tomography after trauma. Acad Emerg Med 2024;
Study Overview:
A retrospective study analyzed 9,455 cervical spine CTs (CSCTs) performed on trauma patients aged ≥65 years at two EDs between 2018–2023, aiming to assess the necessity of routine imaging in asymptomatic older adults.Key Results:
Only 192 patients (2%) had cervical spine fractures; 28 (14.6%) were asymptomatic.
Asymptomatic individuals aged 65–70 had the lowest fracture incidence (0.18%), suggesting routine imaging may be unnecessary in this subgroup.
Study Methods:
Patients classified as asymptomatic had no neck pain, no physical exam findings, and reliable histories.
Exclusions included altered mental status, intoxication, dementia, or unreliable history.
Implications:
Routine CSCT in asymptomatic trauma patients aged 65–70 presents minimal clinical yield and may be safely reduced with shared decision-making and revised protocols.
These findings support moving toward symptom-driven imaging strategies for appropriate older adults.
Limitations:
Single health system study limits generalizability.
Exclusion of altered or impaired patients underrepresents a critical trauma demographic.
Age-based protocols need further validation across diverse populations.
Thoughts for Application:
The findings support revising imaging protocols to exclude asymptomatic patients aged 65–70, aligning with data-driven, cost-effective care while minimizing unnecessary radiation exposure.
Authorship
Written by: Saie Joshi, MD, PGY-3, University of Cincinnati Department of Emergency Medicine.
Editing and Posting by: Jeffery Hill, MD MEd, Associate Professor, University of Cincinnati Department of Emergency Medicine
Cite as: Joshi, S. Hill, J. Is Old Age a Reason to Scan a Cervical Spine? TamingtheSRU. www.tamingthesru.com/blog/journal-club/elderlyCT. 6/18/2025.
