C-Spine Clearance in Trauma

Background: The rate of cervical spine injury associated with maxillofacial fractures varies in the literature from approximately1% to 12% with increasing risk based on the severity of the facial trauma. While patients may frequently be assessed by emergency department practitioners or the trauma team, the oral and maxillofacial surgeon (OMS) must be attentive to the possible risk. Objective: To review the literature to provide an evidenced-based recommendation for obtaining cervical spine clearance in adult and pediatric patients. Design: Systematic review. Methods: A qualitative synthesis was performed on 33 of 94 articles from 2008 to 2025 pertaining to adult trauma patients and 11 of 33 articles from 2016 to 2025 pertaining to pediatric trauma patients. Results: For adult patients, the consensus was to first obtain a CT scan. The negative predictive value for a CT scan with multiplanar reconstruction to rule out a significant or unstable cervical injury in the adult patient was r more...