The objective of the current study was to evaluate the
accuracy of the clinical examination of the spine following
blunt trauma in
intoxicated patients. Methods included a retrospective review of all cases of
blunt trauma presenting to an urban level I
trauma centre over 1 year. Data was analysed separately for the clinical examination of the
cervical spine (CS) and for the
thoracic and
lumbar spine (T + LS). Two hundred and sixteen cases of
blunt trauma secondary to MVC (n = 143) or falls (n = 73) were retained for analysis. In
intoxicated patients, sensitivities and specificities for CS tenderness were 60.0 and 64.3% (
radiological abnormality) and 100 and 68.6% (operative stabilization), respectively.
With respect to the T + LS in
intoxicated patients; sensitivities and specificities for T + LS tenderness and
radiological abnormality were 80.0 and 71.4% and for the ability of the clinical examination to pick up
unstable T + LS fractures requiring operative stabilization 100 and 72.0%, respectively.
Intoxicated blunt trauma patients may be able to have spine fractures requiring operative stabilization excluded using physical examination of the spine at presentation to the
trauma center.
