Deficiency of plain film radiography in the evaluation of cervical spine injury in high-risk patient – case reports

Sa？etak Aim: to emphasize the deficiencies of plain film radiographs in the evaluation of cervical spine injuries especially in high-risk patients in which this diagnostic procedure is inadequate due to pathoanatomical changes (ankylosing spondilytis, spinal canal stenosis and osteoporosis). Case report: We presented the evaluation of cervical spine injury in two high risk groups (osteoporotic patient and patient with ankylosing spondilytis). Spinal fractures are more common in those two groups and can result from a simple fall. The mechanism of injury in both cases was falling from its height. Initial neurological status was normal, only secondary approach revealed neurological deficit; in 1. case couple of hours after injury and in 2. case nine days after injury. In both cases, MSCT revealed cervical spine fracture. Conclusion: Considering the potential severe consequences of unrecognized and untreated injuries, we wanted to emphasise the need for further research and implementation of appropriate evaluation algorithm in high-risk patients. Due to its high specificity and sensitivity, MSCT should be the method of choice in diagnosing cervical spine fracture in this group of patients