Helical CT scan
- C0-C3: 1 mm cuts
- C3-T1: 2 mm cuts
- Coronal and sagittal reformations
Normal**
- REMOVE CERVICAL COLLAR
Isolated Transverse process fracture of the subaxial spine (C3-T1)***
- REMOVE CERVICAL COLLAR
Abnormal
- Further management (MRI, collar, surgery)
*Obtunded patient
Trauma patient who cannot be clinically evaluated and is older than 16 years.
**Normal helical CT scan
Normal helical CT scan: determined by radiology faculty reading. Exception: significant degenerative changes of the cervical spine. These patients should continue to be managed in a collar until a normal clinical exam is possible or MR demonstrates no spinal cord/ligamentous injury.
***Transverse process fracture
Only on subaxial (C3-T1) vertebrae. See image.
Anatomic borders of the transverse process in a subaxial cervical vertebra.
Literature: Schotanus et al, Spine 35(19), 1 Sept. 2010, pp E965-E970