CPT, owned and trademarked by the American Medical Association (AMA), provides physicians, including neuroradiologists, an opportunity to directly participate in the creation of procedural codes. The Current Procedural Terminology (CPT) system has been the national medical coding standard in the United States 1 since 2000. 2003 349:2510-8.ABBREVIATIONS: AMA American Medical Association CPT Current Procedural Terminology The Canadian C-Spine Rule versus the NEXUS low-risk criteria in patients with trauma. Stiell IG, Clement CM, McKnight RD, Brison R, Schull MJ, Rowe BH, et al. Cervical spine fractures in patients 65 years and older: a clinical prediction rule for blunt trauma. 2000 343:94-9.īub LD, Blackmore CC, Mann FA, Lomoschitz FM. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. ![]() Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI for the National Emergency X-Radiography Utilization Study Group. The Canadian C-Spine Rule for radiography in alert and stable trauma patients. Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, et al. Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Hoffman JR, Schriger DL, Mower W, Luo JS, Zucker M. The NEXUS criteria are simple to use and have been effective in the intended population therefore, the NEXUS criteria are still a valuable clinical tool. ![]() Finally, the comparison study population was very different from that in the original NEXUS population, which included children and intoxicated patients. 1 In addition, about 10 percent of participants in the comparison study were not evaluated using the Canadian C-Spine Rule because physicians were afraid to move the necks of these patients. 2 The comparison study also used different wording for the NEXUS criteria than that used in its original study. The comparison study 5 was conducted in the same hospitals and with the same physicians as the original Canadian C-Spine Rule study. Although these findings seem to suggest that the Canadian C-Spine Rule is more accurate, there were several possible biases against the NEXUS criteria. 5 This study showed that, compared with the NEXUS criteria, the Canadian C-Spine Rule was more sensitive (99.4 versus 90.7 percent) and more specific (45 versus 37 percent) in its intended population. The Canadian C-Spine Rule 2 ( Figure 1 5 ) was prospectively validated in 8,283 Canadian patients it also was compared to the NEXUS criteria in a large clinical trial. The patient with the second missed injury did not have neck pain but had a fracture at the right lamina of C-6 that eventually required laminectomy and fusion. ![]() Of the latter two missed injuries, one was described in one report (but not in others) as an “extension teardrop” fracture the patient refused treatment and was asymptomatic at six weeks. The NEXUS criteria correctly identified 810 out of 818 patients (99.0 percent) with C-spine injury and 576 out of 578 patients (99.7 percent) with clinically significant injury. The study included a broad range of patients, the age range was one to 101 years, and intoxicated patients were included. 3 Patients who did not have C-spine radiography or who had the test for reasons other than trauma were excluded. health centers with blunt trauma who underwent C-spine radiography. 1 The largest of these prospective validation studies included 34,069 patients presenting to 21 U.S. The National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria for C-spine radiography in patients with blunt trauma ( Table 1 1 ) were developed and validated over a 10-year period.
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