The MRI is not covered when the following patient-specific contraindications are present: MRI is not covered for patients with cardiac pacemakers or with metallic clips on vascular aneurysms unless the Medicare beneficiary meets the provisions of the following exceptions: Effective for claims with dates of service on or after July 7, 2011, the contraindications will not apply to pacemakers when used according to the FDA-approved labeling in an MRI environment, or effective for claims with dates of service on or after February 24, 2011, CMS believes that the evidence is promising although not yet convincing that MRI will improve patient health outcomes if certain safeguards are in place to ensure that the exposure of the device to an MRI environment adversely affects neither the interpretation of the MRI result nor the proper functioning of the implanted device itself. For patient comfort, if you are ordering more than one exam please consider scheduling on multiple days. Cervical spine collar clearance in the obtunded adult blunt trauma patient: A systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma. Evaluation of the adult patient with neck pain. The authors stated that the main drawback of this review was the heterogeneity of metrics in the 11 studies. Smith (2014) addressed the question "Can CT alone provide adequate clinical information to clear the cervical spine in the obtunded patient"? The review included 57 studies about MRI under physiologic loading stress performed in an upright or sitting position or under axial loading by using a compression device. Spine (Phila Pa 1976). National Institutes of Health. Backer HC, Wu CH, Perka C, Panics G. Dual-energy computed tomography in spine fractures: A systematic review and meta-analysis. 0000012252 00000 n Contraindications include patients with cardiac pacemakers, implanted neurostimulators, cochlear implants, metal in the eye and older ferromagnetic intracranial aneurysm clips. endstream endobj startxref 2008;64(1):179-189. World Neurosurg. It does not mention the use of dynamic-kinetic MRI. Yamada Y, Demura S, Kato S, et al. The overall pooled incidence was 0.0029 %. Endler and colleagues (2021) noted that cervical spine CT is regularly carried out to exclude cervical spine injury during the initial evaluation of trauma patients. 0000006459 00000 n During the test, the MRI will make a rapid tapping noise. Cost-effectiveness of magnetic resonance imaging in cervical spine clearance of neurologically intact patients with blunt trauma. Cho R, Fu R, Carrino J, et al. 0000010859 00000 n Low back pain is the fifth most common reason for all physician visits. T1 and T2 weighted sagittal images through the lumbar spine are obtained. Intensive Crit Care Nurs. If the provider administers oral or rectal contrast, the . Women who are pregnant should avoid having an elective MRI. Ellenberger C. MR imaging of the low back syndrome. The spine, section 1. PDF MRI & MRA CPT CODES - Derry Imaging 74183. A controlled comparison of myelography, computed tomography and magnetic resonance imaging in clinically suspected lumbar disc herniation. Neurology. The signal data may be subjected to a variety of post-acquisitional processing algorithms to obtain a multiplanar view of the anatomy. %%EOF 2012;172(2):127-132. Certain tumors almost never metastasize to the brain parenchyma. Unfallchirurg. cervical spine MRI without contrast should be performed. Because of heterogeneity between studies, these researchers conducted a qualitative evidence synthesis. The above policy is based on the following references: Last Review MRI provides superior tissue contrast when compared to CT, is able to image in multiple planes, is not affected by bone artifact, provides vascular imaging capability, and makes use of safer contrast media (gadolinium chelate agents). . MRA of the Neck/Carotids with contrast 70549 - MRA of the Neck/Carotids w/o & w/contrast F MR CPT Coding Guide Ph 517-353-5053 (Ext 1) ax 517-432-4394 www.rad.msu.edu Tax ID 83 . Spine. In 10 studies that included information on adverse effects, 5 % to 15 % of participants reported new-onset or worsening pain and neuropathy during MRI under loading stress. Magnetic resonance imaging of the musculoskeletal system. 4. (W/ CONTRAST ONLY) Cardiac Stress Test (4 CPT codes required) 78452 multi study PET (POSITRON EMISSION TOMOGRAPHY) Cardiac Blood Pool Imaging, Gated Equil, Single Study Rest, w/ . In a retrospective study, these researchers examined the diagnostic benefit of additional MRI in patients with blunt trauma who have asymmetry of the LADI and no other cervical injuries. These researchers examined their data in regard to these conflicting hypotheses. These investigators searched PubMed, Embase, and CINAHL through October 2014 for articles published in English in which authors assessed lumbar muscle characteristics on conventional MRI/CT as predictors of future LBP, functional limitations, or physical performance in adults. The authors concluded that combined spine and SIJ MRI added little incremental value compared with SIJ MRI alone for diagnosing patients with nr-axSpA and enhancing confidence in this diagnosis. Ishikawa Y, Shimada Y, Miyakoshi N, et al. CPT Code Tool : CT lumbar spine; w/o contrast : 72131: CT lumbar spine; w/o contrast followed by with contrast . The prevalence of redundant nerve roots in patients with lumbar spinal stenosis is body position dependent: A retrospective observational study with repeated measures design in an upright MRI scanner. Imaging strategies for low-back pain: Systematic review and meta-analysis. Health Quality Ontario. Utility of MRI for cervical spine clearance after blunt traumatic injury: A meta-analysis. Magnetic Resonance Imaging (MRI). Diagnostics and treatment of cervical spine trauma in pediatric patients: Recommendations from the Pediatric Spinal Trauma Group. Variables assessed included severity, CT/MRI specifications, imaging timing, and outcome/follow-up. Several cultures grew multiple organisms, leading to a total of 244 species identified. CPT 70486 is a diagnostic imaging, Read More How To Use CPT Code 70486Continue, Below is a list summarizing the CPT codes for anterior or anterolateral approach technique arthrodesis procedures on the spine (vertebral column). No follow-up was the dominant strategy, with a lower cost and a higher utility. PDF MRI EXAM CPT CODE REFERENCE - Wake Radiology 2004;8(1):99-110. Daffner RH, Weissman BN, Wippold FJ II, et al; Expert Panels on Musculoskeletal and Neurologic Imaging. The LA decreased significantly for both RNR groups from standing to flexed sitting (p < 0.001). 0000005734 00000 n 0000015192 00000 n For evaluation of recurrent symptoms after spinal surgery, MRI with and without gadolinium enhancement, is the preferred method of imaging. Inclusion criteria were randomized controlled trials that compared immediate, routine lumbar imaging (or routine provision of imaging findings) versus usual clinical care without immediate lumbar imaging (or not routinely providing results of imaging) for LBP without indications of serious underlying conditions. If you choose to check-in in our lobby, comie in and stop at the front desk, please arrive at your requested time andenter our comfortable clean reception area with your ID, insurance card and order (if applicable) in hand. MEDLINE, CINAHL and EMBASE databases were searched. Imaging plays a key role in the disease assessment. 0000068868 00000 n Phys Med Rehabil Clin N Am. Sagittal and axial T2-weighted images of the 3 functional postures were evaluated. 72128 - w/o contrast 72129 - w/ contrast. 2015;74(6):985-992. Data from eligible studies were pooled and original scale meta-analyses were performed to calculate overall sensitivity, specificity, positive and negative predictive values, likelihood ratios, and relative risk. PDF CPT CODES for MRI SCANS - mtnmedical.com MRI is generally not indicated if radiographs are normal or show only degenerative changes.". Its major disadvantage over CT is the longer scanning time required for study, making it less useful for emergency evaluations. 1997;52(7):530-534. The efficacy of computed tomography-guided percutaneous spine biopsies in determining a causative organism in cases of suspected infection: A systematic review. Collaboration between interventional radiologists and pathologists is essential to optimize these techniques to ensure optimal results. list-style-type: upper-roman; CPT Code 76641 CPT 76641 describes the ultrasound of the breast in real-time with image documentation, including the axilla when performed,, Read More CPT Codes For Diagnostic Ultrasound Procedures Of The ChestContinue, CPT 70486 is a diagnostic imaging code for computed tomography (CT) scans of the maxillofacial area without contrast material. BR30ZZZ - ICD-10 Code for Magnetic Resonance Imaging (MRI) of Cervical 2020;29(9):2306-2318. There is a very slight risk of an allergic reaction if contrast material is injected. 0000009645 00000 n Walker and co-workers (2021) stated that SEL is caused by an excess of adipose tissue accumulation localized to the thoracic and lumbar regions of the spine. Doyle R. Milliman Robertson Healthcare Guidelines. A new MRI can be indicated every 25 years and more frequent imaging is especially recommended for younger patients with progressive disease. UpToDate [online serial]. Aetna considers dual-energy CT experimental and investigational for the evaluation of bone marrow edema and fracture lines in acute vertebral fracturesbecause the clinical value of this approach has not been established. The positive finding rate among alert, awake patients was 0.72%. Moreover, they stated that a prospective study comparing MRI and kMRI is needed to confirm clinically utility of this technology. There was a worst-case 9 % (161 of 1,718 subjects in 11 studies) cumulative literature incidence of stable injuries and a 91 % NPV of no injury, after coupling a negative high-quality C-spine CT result with 1.5-T MRI, upright x-rays, flexion-extension CT, and/or clinical follow-up. Nevedal AL, Lewis ET, Wu J, et al. } The addition of gadolinium contrast intravenously allows better diagnosis of infection, tumor, or post-surgical epidural fibrosis, and can be ordered subsequently if the non-contrast study is inconclusive". J Trauma. Medline, Embase, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched; 2 independent reviewers identified studies for inclusion and extracted data. 0000035514 00000 n PDF Billing and Coding Guidelines for Magnetic Resonance Imaging (RAD - CMS This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 70486 procedures. Adult low back pain. } The official description of CPT code 72141 is: Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material.. Lumbar spine angles and intervertebral disc characteristics with end-range positions in three planes of motion in healthy people using upright MRI. For the MRI exam, if claustrophobia or anxiety is a problem, the referring physician my wish to prescribe a mild sedative to be given prior to the study. Global Spine J. Chin CT.Spine imaging. Intradural lumbar disc herniations: The role of MRI in preoperative diagnosis and review of the literature. Required fields are marked *. MRI during a viable pregnancy is also contraindicated at this time. Outcomes were categorized as short-term (less than or equal to 3 months), long-term (greater than 6 months to less than or equal to 1 year), or extended (greater than 1 year). Codes requiring a 7th character are represented by "+": . background-color: #cc0066; A patient with a history of spinal surgery presents with new-onset neck pain, and the provider orders an MRI without contrast material to assess the cervical spinal canal and contents. Global and local intervertebral LS angles were measured. list-style-image: url('https://www.aetna.com/cpb/medical/data/assets/images/purplearrow.jpg') !important; Philadelphia, PA: American Board of Internal Medicine; 2013. (IMG 2423) - C-Spine. The patient is instructed to hold their breath and remain still while images of the cervical spine (neck area vertebrae) are taken. . Links to various non-Aetna sites are provided for your convenience only. CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. While the exact pathogenesis is unclear, the etiology of SEL can be broadly classified based on 5 commonly associated risk factors: exogenous steroid use, obesity, endogenous steroid hormonal disease, spine surgery, and idiopathic disease. The largest cohort included 76 patients with 774 vertebrae. }. In the Coverage Indications, Limitations and/or Medical Necessity section, under Computerized Tomography (CT) letter E, the ICD-10 code G44.1 was deleted. 72127 --> With and Without IV Contrast 72130 --> With and Without IV Contrast THORACIC SPINE ORBIT/SELLA (Temporal Bones, Mastoids, IACs) SOFT TISSUE NECK Diagnostic CPT Code Reference Guide CT Scans HEAD MAXILLOFACIAL (Facial Bones, Mandible, Sinus) . background-color: #663399; These researchers used the Newcastle Ottawa Scale to evaluate potential bias. CT SCAN AND CTA CPT codes list 74174 - Radiology billing, Coding Advances in technology and hospital policy regarding specimen acquisition and tissue transfer and handling are needed to ensure the benefits of CT-guided biopsies out-weigh the risks. The appropriate use of these new technologies is still somewhat unsettled. Computed tomography alone versus computed tomography and magnetic resonance imaging in the identification of occult injuries to the cervical spine: A meta-analysis. A Markov model with a 3 % discount rate was used with parameters from the literature. Check individual payer policies for contrast coverage and reportable supply codes. 0000010449 00000 n Cardiac w/ and w/o contrast with stress testing, Temporomandibular Joints w/ and w/o contrast, Chest Wall/Rib, Sternum, Bilateral Pectoralis Muscles, Bilateral Clavicles w/o contrast, Chest Wall/Rib, Sternum, Bilateral Pectoralis Muscles, Bilateral Clavicles w/ and w/o contrast, Spine All indications for C-Spine, T-Spine and L-Spine w/o contrast, Spine All indications for C-Spine, T-Spine and L-Spine w/ and w/o contrast, Cord Compression (Total Spine, Sagittal Screening), MRA Head w/ and w/o contrast (Whole Brain), MRA Head w/ and w/o contrast (Circle of Willis), Pelvis w/o contrast (Body and MSK Pelvis), MRA/MRV Upper Extremity w/ and w/o contrast, Woodard to Lead Mallinckrodt Institute of Radiology, Sauk Named Interventional Radiology Chief, Miller-Thomas Receives Distinguished Service Teaching Award. UpToDate [online serial]. There are some recognized risk factors for SEL, the most common of which are exogenous steroid use and obesity. Lipomatosis was idiopathic in 6 patients and secondary in 14 patients. One study compared immediate MRI or CT with usual clinical care without advanced imaging in patients with mainly chronic LBP (82 % had LBP for greater than 3 months) referred to a surgeon, whereas in the other study all patients with LBP for less than 3 weeks underwent MRI, with randomization to routine notification of results within 48 hours versus notification of results only if clinically indicated. Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis? In the retrospective review of obtunded blunt trauma patients, none was later diagnosed to have significant cervical spine injury that required a change in clinical management. MRA carotid with contrast. Research synthesis: What is the diagnostic performance of MRI to discriminate benign from malignant vertebral compression fractures? Some studies employed a composite reference including microbiological diagnosis or histopathology, radiological appearance, and clinical response to anti-microbial therapy; whereas others utilized positive microbiology or histopathology alone or heavily relied on clinician judgment. J Trauma Nurs. Common Procedure Codes (CPT) For Imaging Procedures CT MRI (cont.) Upright MRI after decompression of spinal stenosis and concurrent spondylolisthesis. A systematic review. Previously, invasive modalities were required to obtain information that is now available with non-invasive technologies. 2022;32(1):561-571. A favorable outcome was reported in 85 % of patients with disk herniation and 83 % without disk herniation (p = 0.70). 1. The authors concluded that given the typically low-quality evidence, definitive conclusions could not be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain-free controls. All these factors could potentially influence BME evaluation and CT numbers on VNCa series. The authors concluded that in obtunded adult blunt trauma patients, they conditionally recommended cervical collar removal after a negative high-quality C-spine CT scan result alone. 2000;215(Suppl):495-505. Seidenwurm D, Drayer BP, Anderson RE, et al. A patient with a history of spinal infections undergoes an MRI without contrast material to assess the cervical spinal canal and contents for any signs of infection or inflammation. In the axial view: disc width, left and right foraminal height. According to accepted guidelines, MRI is the preferred method of imaging for each ofthe medically necessary indications listed in the Policy section, with the exception of. These investigators presented the findings of a retrospective study of the charts of 20 patients (17 men and 3 women); average age of 64 years. They stated that these findings indicated that epidural fat of the lumbar spine contributed to neurological deficits. For intravascular, intraarticular, or intrathecal contrast, a separate code may be used. Magnetic Resonance Imaging (MRI) is a non-invasive diagnostic scanning technique that employs a powerful and highly uniform static magnetic field, rather than ionizing radiation, to produce images. CERVICAL SPINE 72125- W/O CONTRAST 72126- W/ CONTRAST 72127- W/O & W/ CONTRAST CHEST 71250- W/O CONTRAST 71260- W/ CONTRAST 71270- W/O & W/ CONTRAST THORACIC SPINE . right: 30px; This Clinical Policy Bulletin addresses magnetic resonance imaging (MRI) and computed tomography (CT) of the spine. Neuroradiology 2020;62(8):979-985. 2000;29(11):632-639. padding: 10px; Systematic review and meta-analysis. TX77. It is found in the 2022 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2021 - Sep 30, 2022 . Khanna and associates (2012) stated that the value of MRI in the evaluation of the obtunded or comatose patient with a potential neck injury is a controversial subject. Waltham, MA: UpToDate; reviewed December 2019. Often combined with MRA Neck and MRI Brain, Requires MRI Brain w/ and w/o, CPT code 70553, CPT Codes 70554 & 76377 (IMG 2390) fMRI (Functional MRI w/ Tractography), CPT Codes 70551 & 76377 (IMG 2649) Volumetric Imaging (3T), CPT Codes 70553 & 76377 (IMG 2387) DTI Brain w/ Tractography, CPT Codes 70553 & 72156 (IMG 2360) CSF Flow Study, See list of indications for MRI Abdomen w/ and w/o contrast, See list of indications for MRI Abdomen & Pelvis w/ and w/o contrast, See list of indications for MRA Abdomen w/ and w/o contrast, See list of indications for MRA/MRV Pelvis w/ and w/o contrast). text-decoration: underline; Spine: Cervical RAD07074 MRI Cervical Spine without and with Contrast 72156 Spine: Thoracic RAD07228 MRI Thoracic Spine without Contrast 72146 2023 Guilford Radiology. PDF Magnetic Resonance Imaging - Mri Magnetic Resonance Angiograhy - Mra MRI can accurately assess for degenerative disc disease as well as disc herniation. background-position: right 65%; In patients with back pain that cannot be attributed to a specific disease or spinal abnormality following a history and physical examination (e.g., non-specific low back pain), imaging with plain radiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI) does not improve patient outcomes. The area under the receiver-operating-characteristic (ROC) curve was used to assess the prognostic accuracy of the 4-point scores regarding a favorable or unfavorable outcome, with 1 indicating "perfect discriminatory value" and 0.5 or less indicating "no discriminatory value". Patients with cardiac pacemakers, ICD, or neuro-stimulators CAN NOT have an MRI. The 1996 to 2007 Health and Retirement Study Medicare claims-linked database was used to identify individuals with an incident diagnosis of peripheral neuropathy using International Classification of Diseases, Ninth Revision, codes and required no previous neuropathy diagnosis during the preceding 30 months. } This study was a retrospective analysis of all cases of lumbar spinal stenosis treated at the Frankfurt University Clinic (Universittsklinik Frankfurt) from 2010 through 2013. Implementation of institutional triaging algorithms decreases head and neck MDCT use in blunt trauma. Furthermore, 5 studies reported the accuracy of CT with an overall sensitivity of 81.3 %, specificity of 80.7 %, and accuracy with 80.9 %. Please do not bring anyone with you to your exam as we are trying to reduce traffic in our office, special accommodations can be made as needed. CPT Code 72157 (IMG 2425) - T-Spine. Spine. .newText { %PDF-1.5 % CPT 73718 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) MRI Cervical Spine w/o Contrast. Some authors have suggested that MRI of the cervical spine adds no value in the evaluation of patients with a normal CT of the neck. Endler CH, Ginzburg D, Isaak A, et al. See list of indications for MRI Chest w/ and w/o contrast, Patient with renal insufficiency or hemodialysis, Cardiomyopathy / right ventricular dysplasia, Any of the above with valve disease (Add CPT Code 75565 Cardiac MRI for velocity flow mapping), Patient with renal insuffi ciency or hemodialysis, Rib fracture, costochondral cartilage injury, Muscle, tendon (rotator cuff) or nerve injury, Triangular fibrocartilage (TFC) complex injury, Inflammatory arthritis, synovitis, erosions, Inflammatory arthritis, synovitis, erosions, sacroiliitis, Muscle, ligament (Lisfranc), tendon or nerve injury, Meniscus, ligament (ACL) tendon or nerve injury, B2 headache/acute trauma/shunt evaluation/stroke/renal insufficiency/hemodialysis, B3 memory loss/dementia/Alzheimers disease/normal pressure hydrocephalus, B2 new seizure evaluation (Add CPT Codes 70544 & 70549; MRA Head W/O and MRA Neck w/ and w/o to include angiograms), B2 sinus thrombosis (Add CPT Code 70546 MRA/MRV Head W and W/O), B2 suspected brain tumor/rule out metastatic disease, B3 known brain tumor/metastatic disease (includes perfusion and 3-D sequences), B12 elevated prolactin levels/pituitary lesions (microadenoma or macroadenoma), B6 high resolution temporal lobe/chronic seizures (epileptic) (3T), E9 high resolution skull base/tinnitus/cholesteatoma/sensorineural hearing loss/acoustic, neuroma/ Bells palsy/Menieres disease/cranial nerves V, VII-XII, (E9 does not include whole brain unless specifically requested), E1 Orbits A high resolution exam to include the orbits and optic pathways, Exophthalmos/proptosis Optic neuritis/optic nerve lesion/tumor/infection, Diplopia/double-vision Cranial nerves I-VI, Visual field defect Perineural spread of tumor, E3 Face and Paranasal Sinuses A high-resolution exam of the face and sinuses, Known or suspected lesion in oropharynx/nasopharynx/tongue /floor of mouth, E2 Neck (Soft Tissue) A survey exam imaging from above the orbits to the thoracic inlet, Known or suspected lesion in thyroid/parathyroid/parotid gland, Evaluate for mass lesions, entrapment or denervation, Known or suspected arteriovenous malformation (Requires MRI Brain w/ and w/o contrast, CPT code 70553) IMG2337, Liver/pancreas lesion characterization (Add 3D CPT Code 76376) IMG 2579 (NPO 4 HOURS), Dilatation of intrahepatic bile duct/biliary tree/Carolis disease/RUQ pain, Hepatocellular carcinoma /hepatitis/cirrhosis, Known or suspected liver/pancreatic lesion, Prep: NPO after midnight; a light diet of liquids is allowed for PM appointments and diabetic patients, MR enterography/enteroclysis with cancer for fistula IMG2678, MR urogram (evaluation of kidneys, ureters and bladder) IMG7758, Urinary tract dilation or urinary obstruction, Uterine anomaly/malformation (body pelvis), Pregnant appendicitis/RLQ pain (body pelvis), Pubalgia/sports hernia (bony pelvis) Patient with renal insufficiency, Lumbosacral plexus mass/lesion/plexopathy, Prep: Dulcolax suppository night before exam, light dinner night before exam, and only clear liquids day of exam, Hernia (incisional, laparoscopic, ostomy, femoral or inguinal), Urethral diverticulum/urethral cancer/ periurethral mass (with endovaginal coil), (Patient should be informed, exam requires endovaginal coil to be inserted and remain for entire exam. how often can cpt 77336 be billed ? Wu X, Malhotra A, Geng B, et al. North American Spine Society. Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? Measures were done L3/L4, L4/L5 and L5/S1. Olympia, WA: Washington State Department of Labor and Industries; June 1999. 0000070528 00000 n At 1 year, 84 % of the patients reported having a favorable outcome. Mri spine thoracic w/ & w/o 72157. A specialized coil will be placed around your patients neck. 72125 - w/o contrast 72126 - w/ contrast. Ann Intern Med. CPT Codes For Urinalysis | CPT 81000 CPT 81099, CPT Code 90785 | Description & Clinical Information, CPT Codes For Diagnostic Ultrasound Procedures Of The Chest, CPT Codes For Anterior Or Anterolateral Approach Technique Arthrodesis Procedures On The Spine (Vertebral Column). Brain and Neck : Joints : MRI Brain, IAC's or Pituitary w/o Contrast. Age and type of vertebra have been considered as potential factors influencing bone marrow composition, and differences in bone mineral density (BMD) could influence attenuation values on VNCa images. 2022;47(22):E617-E624. o9O|Q/0s9smsVYwp' M 1tW}1 1Y%c_qz*7_)mATvozt#V /fl)9xoq(-=[k"}?M-I6zF4hs3qL75{so=C7U-rYeYsYt_q(qbko]G+Q@k%0on%gq -H;G)Ug^FEplsNy~\^A[dVTVR2Hs[x#{E#Q. Helical CT in the primary trauma evaluation of the cervical spine: An evidence-based approach.