Determinants of Spine Radiography among Patients with Severe Trauma

Abstract

Introduction: Radiographs have low sensitivity in detection of cause-specific backpain that resulted from trauma or infection. Thus, radiography could be considered as an initial diagnostic modality for backpain before referral to more sophisticated radiological techniques. The aim of the review is to study the determinants of spine radiography, particularly in patients with severe trauma.
Methods: The following databases were searched without language restrictions for articles published in any year up to January 2022: “PubMed, MEDLIN, EMBASE, and Google-Scholar”. Designing and conducting the electronic search strategy were performed by an expert reference librarian based on input data from investigators. The database searches were supplemented with manual searches of reference lists of the potentially eligible articles. Article about spine or pelvic radiography were included in this study.
Results: Several studies aimed to assess methodological radiographic factors that can improve the performance of radiography in different parts of the body. many studies focused on pelvic radiography found that body positioning and axial load were significant predictors for radiation dose and image quality. In lumber supine region, the most common cause of spinal pain in 70% of cases is diagnosed as “non-specific”. In such cases, radiographic assessment is recommended for patients with chronic backpain, patients with osteoporosis, patients suspected to have vertebral compression problems, or those under steroids treatment.
Conclusions: Improvement of the performance by identifying the key operational factors, in the lumber spine region, may significantly reduce the rejection rate of radiographs in the clinical practice.