The AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves, under the direction of Dr. Mark Hadley and Dr. Beverly Walters, has completed an evidence-based review of literature pertaining to the treatment of cervical spine trauma and spinal cord injury. This work represents a monumental effort of many prominent experts in spinal surgery and embraces twenty-two clinical questions ranging from immobilization in the field, to the role of Methylprednisolone after acute spinal cord injury. The evidence took two years to compile and analyze.

The end result, Practice Guidelines in the Treatment of Cervical Spine and Spinal Cord Injury, was published under separate cover as a supplement to the March 2002 issue of the journal Neurosurgery. This publication has become the reference manual for all clinicians involved in treating cervical spine injuries from the paramedics in the field, to the rehabilitation specialists involved in long-term follow-up.

We are continuing to publish a synopsis of each of the recommendations in this and subsequent editions of Neurosurgery News. The following is an excerpt from Chapter 4 of 22. This chapter is notable in that there exists excellent Class I evidence that provides a set of intuitive and reliable rules to answer the age old dilemma of “to image or not to image”. Here is a PRACTICE STANDARD that we should all make part of our personal decision trees.