Cervical Spine CT Outnumbers Radiography in ED

Cervical spine radiography numbers down, but CT use climbing, according to a study presented at ACR 2016.

Cervical spine imaging in the emergency department (ED) represents the largest portion of growth in CT use, according to a presentation at the 2016 annual meeting of the American College of Radiology.

Researchers from Georgia and Virginia undertook a study to assess the changing utilization of cervical spine imaging in the ED. Using national aggregate Medicare Physician Supplier Procedure Files, the researchers gathered data on all cervical spine radiography, CT, and MR examinations performed in the ED setting.

The results showed that use of cervical spine radiograph in the ED among Medicare patients increased 50.5% from 1994 to 2004, but then decreased by 50.2% by 2012. Cervical CT volumes increased every year, by 8864% from 1994 to 2012, and MR imaging grew by 1381%:

 Number of Examinations in 1994Number of Examinations in 2004Number of Examinations in 2012
Cervical Spine Radiography Volumes203,645306,442152,755
Cervical CT Volumes6,360-570,121
MR Images944-13,979






According to the researchers, CT overtook radiography as the dominant ED cervical spine imaging modality in 2007. Changes per 1,000 Medicare beneficiaries:

 Change from 1994-2012






Radiologists remain the dominant providers of the examinations:







The researchers concluded there was an average annual 1.9% decrease in radiography of the cervical spine in this population, and a 25.9% increase in CT utilization, making CT by far the dominant ED imaging modality.