July 23, 2010
HOUSTON - In a study of the original CT scans and records of patients who survived severe car accidents and were transferred alive to a Level 1 Trauma Center but subsequently died within 21 days of arrival, researchers found that 30 percent had injuries to the upper spine and surrounding area which might have been detectable by CT scans before they died. The report, funded by the Michael E. DeBakey VA Medical Center, appears in The Spine Journal.
“Occipitocervical dissociative injuries are injuries that include any kind of severe injury that includes damage to the soft tissue connecting the vertebral segments of upper cervical spine,” said John Hipp, Ph.D., Spine Lab director, and one of the researchers involved in the study.
Cervical spine injuries are the most common injury associated with car accidents, and Hipp and his colleagues sought to find out how often such injuries took place in trauma patients and if doctors could have detected them before a patient died.
In this study, researchers studied 74 consecutive patients who were rescued from the car wreck but died within 21 days of their injuries and had a CT scan of the cervical spine as part of their original workup. (A computed axial tomography scan, or CT or CAT scan, is a series of X-rays of an area that results in a three-dimensional image.)
They found that these injuries, which include damage to the connection between spine and skull, occurred in nearly 30 percent of the cases. Previous forensic studies had shown a similar percentage. The researchers said it may be possible to detect these kinds of soft and hard tissue injuries in CT scans using careful measurement.
“We cannot today say why these patients died,” said Hipp. “We cannot say that they died because of this injury. The only thing we can say is that they died, and before they died, they did have on their CT scans findings that suggest that this might have been one of the significant pathologies that they had. We don’t have a gold standard because this was a retrospective study.”
“Now that we know that these injuries are occurring, our radar might need to be tuned up to look for these injuries in the future,” said Hipp.
Others who took part in the study include Peleg Ben-Galim, M.D., Niv Dreiangel, M.D., and Ran Lador, M.D. of Baylor College of Medicine.