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Chiropractic Research Review

Evaluating Spinal Trauma: Diagnostic Considerations

Trends in health care are shifting strongly toward increased accountability. In the third-party payment and legal liability arenas, requests to objectify physical examination findings, clinical status, and need for care are routinely made.

This is especially true of tauma cases involving litigation.

This literature review examines the emerging technological advancements that are providing new ways for physicians to evaluate clinical presentations of spine trauma. It considers the motivations for ordering and the rationales for the utilization of diagnostic instrumentation in spinal trauma from payer, medicolegal and clinical perspectives. These evolving, costly and controversial diagnostic technologies add new challenges to patient care.

The article focuses on the clinical utility of plain film radiographic imaging, surface electromyography, computerized inclinometry and videofluoroscopy. Interesting practice case scenarios and a breakdown of literature on each specific modality are included. Parameters for evaluating the clinical utility of diagnostic modalities are provided and different viewpoints, from patients to practitioners, are considered in the discussion regarding the necessity of these modalities.

While there will likely be a continuing tendency to call on diagnostic instrumentation in the evaluation of trauma, the most important basis for deciding on its use should be clinical rationale. However, future applications should be assessed for impact on patient care, clinical decision making and diagnostic triage, thereby helping to ensure the most appropriate use of resources and the most efficacious approach to patient care.

McMillan AD. The role of diagnostic instrumentation in the evaluation of spine trauma. Topics in Clinical Chiropractic, Sept. 1998;5(3), pp46-53. Reprints: (800) 638-8437

Chiropractic Research Review

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