Thanks Tim,Rowley and Charlie for your experience.The best paper I could find
addressing this was in Journal of Trauma 1994 Oct;37(4)673-676 by Frankel and
Rozycki.They retrospectively studied relative risk from data review of traumatic
thoracolumbar fractures and applied these prospectively using 7 risk entrance
criteria(essentially covering mechanism and symptomatology) mandating surveillance
X-ray and apparently have not missed any fractures in their study.Disturbingly
40%(26/65) of their prospectively identified fractures had no symptoms(back
pain/tenderness) and had X-ray done for indications related to mechanism or
associated c-spine #.Need we be more vigilant with our screening
Dilip
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