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Imaging the spine for tumour and trauma–a national audit of practice in Irish hospitals

BACKGROUND AND PURPOSE: The provision of appropriate spinal imaging in cases of acute injury as a consequence of trauma or tumour is becoming ever more challenging. This study assessed the use of multimodal radiological investigations in the management of spinal cord compression as a result of trauma and metastatic cancer in all major Irish hospitals. METHODS: We conducted a questionnaire of thirty four hospitals in an effort to assess the provision of these services to patients with possible spinal cord compromise. In all public hospitals the Emergency Department and/or the Orthopaedic Registrars were contacted and asked a series of questions relating to spinal clearance, spinal clearance protocols, CT and MRI scanning facilities and on site orthopaedic services. RESULTS: All centres participated in the study. 67.64% of centres routinely used a protocol in spinal clearance. In 87% of hospitals the Emergency department were responsible for clearing the spine. 85.3% of hospitals had CT availability during normal working hours (9-5) dropping to 47% availability after hours. MRI was available in 50% of hospitals, with surprisingly just two centres providing out of hours MRI imaging services. CONCLUSION: The provision of radiological services in the management of suspected spinal injuries in Irish hospitals is inadequate in comparison to international best practice. This is most marked in relation to CT and MRI

Keywords : Clinical Protocols,complications,diagnosis,Emergency Service,Hospital,etiology,Health Care Surveys,Health Services Accessibility,Hospitals,Hospitals,Public,Humans,injuries,Ireland,Magnetic Resonance Imaging,Medical Audit,methods,Patients,Prospective Studies,secondary,Spinal Cord,Spinal Cord Compression,Spinal Cord Injuries,Spinal Cord Neoplasms,Spinal Injuries,Spine,statistics & numerical data,surgery,Surveys and Questionnaires,Tomography,X-Ray Computed,Universities,, Spine,Tumour, deep tissue massage for back pain

Date of Publication : 2012 Apr

Authors : Kelly JC;O’Briain DE;Kelly GA;Mc Cabe JP;

Organisation : Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland. johncokelly@gmail.com

Journal of Publication : Surgeon

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/22385529

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