ACR Appropriateness Criteria® Acute Spinal Trauma: 2024 Update

Due to its wide spectrum of injury patterns, imaging of acute blunt spine trauma can present many challenges. CT is generally the first-line imaging modality, as it is fast, accurate, and easily accessible. Choice of appropriate imaging is important, as overuse of imaging is associated with prolonged emergency visits and unnecessary hospital admission, potentially leading to iatrogenic injuries and an increase in economic burden. In contrast, failure to identify injuries can have severe consequences.

The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.