In a study of original CT scans and records of patients who survived severe car accidents, were transferred alive to a Level 1 Trauma Center but subsequently died within 21 days of arrival, experts at Baylor College of Medicine found that 30 percent had injuries to the upper spine and surrounding area which might have been detectable by CT scans before they died. The report appears in The Spine Journal.

"Occipitocervical dissociative injuries are injuries that include any kind of severe injury that includes damage to the soft tissue connecting the vertebral segments of upper cervical spine," said Dr. Peleg Ben-Galim, assistant professor of orthopedic surgery at BCM and one of the researchers involved in the study.

Cervical spine injuries are the most common injury associated with car accidents, and Ben-Galim and colleagues sought to find out how often such injuries took place in trauma patients and if doctors could have detected them before a patient died.

Soft, hard tissue injuries

In this study, researchers studied 74 consecutive patients who were rescued from a car wreck but died within 21 days of their injuries and had a CT scan of the cervical spine as part of their original workup. (A computed axial tomography scan, or CT or CAT scan, is a series of X-rays of an area that results in a three-dimensional image.)

They found that these injuries, which include damage to the connection between spine and skull, occurred in nearly 30 percent of the cases. Previous forensic studies had shown a similar percentage. The researchers said it may be possible to detect these kinds of soft and hard tissue injuries in CT scans using careful measurement.

Look for this type of injury

"We cannot today say why these patients died," said Ben-Galim. "We cannot say that they died because of this injury. The only thing we can say is that they died, and before they died, they did have on their CT scans findings that suggest that this might have been one of the significant pathologies that they had. We don't have a gold standard because this was a retrospective study."

"Now that we know that these injuries are occurring, our radar might need to be tuned up to look for these injuries in the future," said Ben-Galim.

Others who took part in the study include Drs. Niv Dreiangel, Ran Lador of BCM and Dr. John Hipp of BCM and the Michael E. DeBakey Veterans Affairs Medical Center.

Funding for this work came from the Michael E. DeBakey Veterans Affairs Medical Center.