Diagnostic yield and number needed to screen for cervical and concomitant spinal injuries in geriatric head trauma.
Cervical spine injury occurred in 6% of geriatric head trauma patients.
Diagnostic yield and number needed to screen for cervical and concomitant spinal injuries in geriatric head trauma.
Geriatric patients with head trauma face an increased risk of cervical spine injuries (cervical spine injuries) and concomitant spinal injuries (concomitant spinal injuries).
Aged ≥65 years presenting after head trauma to a Level I trauma center between January 2020 and October 2025, undergoing cCT and cervical spine cCT, were analyzed.
Conservative treatment of cervical spine injuries was employed in 75.2%, while dorsal instrumentation was the most performed operative technique (63.4%).
Risk factors for cervical spine injuries included advanced age (OR = 1.1, p = 0.03), ankylosing spinal disease (OR = 5.9, p < 0.001) and thoracic trauma (OR = 2.9, p < 0.001).
The number needed to screen for incremental yield of csMRI was 54.9 for patients aged ≥65 years and 45.3 for those aged ≥80 years.
Among patients undergoing additional csMRI, subaxial injuries were observed in 45.6%, with 70.0% being treated conservatively.
Cervical spine injuries are common in geriatric head trauma and frequently accompanied by concomitant spinal injuries.
Given the low number needed to screen, a liberal use of extended imaging, including whole-spine cCT and selective csMRI, can be considered to improve patient safety. LEVEL OF EVIDENCE: III, survey.