State of play: clearing the thoracolumbar spine in blunt trauma victims

IntroductionThe present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies.MethodsA comprehensive literature search was performed, and articles identified were critically appraisedResultsTwenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols are presented. The evolution of imaging strategies in response to new technology is described.ConclusionsThoracolumbar spine screening is best done using reformatted images acquired when scanning the chest and abdomen of high-risk multi-trauma patients. If computed tomography is not clinically indicated for investigation of other injuries then plain films are the first line investigation.Marten C. Howes and Andrew P. Pearc