Blunt cervical spine injury in children

Current Opinion in Pediatrics

Volumn 24, Issue 3, 2012, Pages 301-306

  Tilt, Lindsey ^a   Babineau, John ^a   Fenster, Daniel ^a   Ahmad, Faiz ^a   Roskind, Cindy G ^a  

^a New York Presbyterian Columbia University Medical Center   (United States)

Author keywords

cervical spine injury; computed tomography scan; flexion extension; MRI; spinal cord injury without radiographic abnormality; spinal immobilization

Indexed keywords

BLUNT TRAUMA; CERVICAL SPINE INJURY; CHILDHOOD INJURY; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC VALUE; EMERGENCY CARE; EMERGENCY HEALTH SERVICE; FLEXOR REFLEX; FRACTURE IMMOBILIZATION; HIGH RISK PATIENT; HUMAN; ILLNESS TRAJECTORY; INJURY SEVERITY; INTOXICATION; MENTAL HEALTH; NECK PAIN; NEUROLOGIC DISEASE; NUCLEAR MAGNETIC RESONANCE IMAGING; NURSING PRACTICE; PARESTHESIA; PRIORITY JOURNAL; RADIOGRAPHY; REVIEW; RISK ASSESSMENT; TORTICOLLIS; TRAFFIC ACCIDENT; UNCONSCIOUSNESS;

CERVICAL VERTEBRAE; CHILD; EMERGENCY MEDICAL SERVICES; HUMANS; IMMOBILIZATION; MAGNETIC RESONANCE IMAGING; RISK ASSESSMENT; SPINAL INJURIES; TOMOGRAPHY, X-RAY COMPUTED; TRIAGE; WOUNDS, NONPENETRATING;

EID: 84861097549     PISSN: 10408703     EISSN: 1531698X     Source Type: Journal    
DOI: 10.1097/MOP.0b013e3283527035     Document Type: Review

References (47)

1. Viccellio P, Simon H, Pressman BD, et al. A prospective multicenter study of cervical spine injury in children. Pediatrics 2001;108:e20.
2. Platzer P, Jaindl M, Thalhammer G, et al. Cervical spine injuries in pediatric patients. J Trauma 2007;62:389-396; discussion 394-396.
3. Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery 2004;55:1325-1342; discussion 1342-1343.
4. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support. 8th ed. Chicago: American College of Surgeons; 2008.
5. Foltin GL, Dayan P, Tunik M, et al. Priorities for pediatric prehospital research. Pediatr Emerg Care 2010;26:773-777.
6. Kwan I, Bunn F. Spinal immobilisation for trauma patients [review]. The Cochrane Database Syst Rev 2001: CD002803. doi: 10.1002/14651858. CD002803.
7. Schafermeyer RW, Ribbeck BM, Gaskins J, et al. Respiratory effects of spinal immobilization in children. Ann Emerg Med 1991;20:1017-1019.
8. Domeier RM, Frederiksen SM, Welch K. Prospective performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance criteria. Ann Emerg Med 2005;46:123-131.
9. Domeier RM, Swor RA, Evans RW, et al. Multicenter prospective validation of prehospital clinical spinal clearance criteria. J Trauma 2002;53:744-750.
10. Stiell IG, Wells GA, Vandemheen KL, et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA 2001;286:1841-1848.
11. Hoffman JR. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 2000;343:94-99.
12. Leonard JC, Kuppermann N, Olsen C, et al. Factors associated with cervical spine injury in children after blunt trauma. Ann Emerg Med 2011;58:145-155. This is a large multicenter case-control study that used multivariate regression to develop an eight-variable decision model that identifies children at low risk of CSI.
13. Lee SL, Sena M, Greenholz SK, Fledderman M. A multidisciplinary approach to the development of a cervical spine clearance protocol: process, rationale, and initial results. J Pediatr Surg 2003;38:358-362; discussion 358-362.
14. Pieretti-Vanmarcke R, Velmahos GC, Nance ML, et al. Clinical clearance of the cervical spine in blunt trauma patients younger than 3 years: a multicenter study of the American association for the surgery of trauma. J Trauma 2009;67:543-549; discussion 549-550.
15. Vaillancourt C, Stiell IG, Beaudoin T, et al. The out-of-hospital validation of the Canadian C-Spine Rule by paramedics. Ann Emerg Med 2009;54:663-671; e1.
16. Stiell IG, Clement CM, O'Connor A, et al. Multicentre prospective validation of use of the Canadian C-Spine Rule by triage nurses in the emergency department. CMAJ 2010;182:1173-1179.
17. Meek R, McGannon D, Edwards L. The safety of nurse clearance of the cervical spine using the National Emergency X-radiography Utilization Study low-risk criteria. EMA 2007;19:372-376.
18. Mohseni S, Talving P, Branco BC, et al. Effect of age on cervical spine injury in pediatric population: a National Trauma Data Bank review. J Pediatr Surg 2011;46:1771-1776. This is a large retrospective analysis of a National Trauma Bank describing CSI epidemiology in pediatric patients.
19. Brown RL, Brunn MA, Garcia VF. Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg 2001;36:1107-1114.
20. Eleraky MA, Theodore N, Adams M, et al. Pediatric cervical spine injuries: report of 102 cases and review of the literature. J Neurosurg 2000;92(Suppl 1):12-17.
21. Watson G, Upadhyay V. Paediatric cervical spine injuries: an audit of 22 acute injuries and literature review. Injury Extra 2005;36:469-474.
22. Zuckerbraun B. Effect of age on cervical spine injuries in children after motor vehicle collisions: effectiveness of restraint devices. J Pediatr Surg 2004;39:483-486.
23. Kokoska ER, Keller MS, Rallo MC, Weber TR. Characteristics of pediatric cervical spine injuries. J Pediatr Surg 2001;36:100-105.
24. Yanar H, Demetriades D, Hadjizacharia P, et al. Pedestrians injured by automobiles: risk factors for cervical spine injuries. J Am Coll Surg 2007;205:794-799.
25. Anderson RC, Kan P, Vanaman M, et al. Utility of a cervical spine clearance protocol after trauma in children between 0 and 3 years of age. J Neurosurg 2010;5:292-296. This study prospectively evaluated the test characteristics of a cervical spine clearance protocol in preverbal children.
26. Ehrlich PF, Wee C, Drongowski R, Rana AR. Canadian C-spine Rule and the National Emergency X-Radiography Utilization low-risk criteria for C-spine radiography in young trauma patients. J Pediatr Surg 2009;44:987-991.
27. Garton HJ, Hammer M. Detection. Neurosurgery 2008;62:700-708.
28. Khan SN, Erickson G, Sena MJ, Gupta MC. Use of flexion and extension radiographs of the cervical spine to rule out acute instability in patients with negative computed tomography scans. J Orthop Trauma 2011;25:51-56.
29. Insko EK, Gracias VH, Gupta R, et al. Utility of flexion and extension radiographs of the cervical spine in the acute evaluation of blunt trauma. J Trauma 2002;53:426-429.
30. Ralston ME, Chung K, Barnes PD, et al. Role of flexion-extension radiographs in blunt pediatric cervical spine injury. Acad Emerg Med 2001;8:237-245.
31. Goodnight TJ, Helmer SD, Dort JM, et al. A comparison of flexion and extension radiographs with computed tomography of the cervical spine in blunt trauma. Am Surg 2008;74:855-857.
32. Duane TM, Cross J, Scarcella N, et al. Flexion-extension cervical spine plain films compared with MRI in the diagnosis of ligamentous injury. Am Surg 2010;76:595-598. This is a retrospective observational study comparing the test characteristics of flexion-extension films with MRI in the diagnosis of ligamentous injury in adult patients with CSI.
33. Holmes JF, Akkinepalli R. Computed tomography versus plain radiography to screen for cervical spine injury: a meta-analysis. J Trauma 2005;58:902-905.
34. Sanchez B, Waxman K, Jones T, et al. Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma 2005;59:179-183.
35. Mathen R, Inaba K, Munera F, et al. Prospective evaluation of multislice computed tomography versus plain radiographic cervical spine clearance in trauma patients. J Trauma 2007;62:1427-1431.
36. Gonzalez RP, Cummings GR, Phelan HA, et al. Clinical examination in complement with computed tomography scan: an effective method for identification of cervical spine injury. J Trauma 2009;67:1297-1304.
37. Bailitz J, Starr F, Beecroft M, et al. CT should replace three-view radiographs as the initial screening test in patients at high, moderate, and low risk for blunt cervical spine injury: a prospective comparison. J Trauma 2009;66:1605-1609.
38. Holmes JF, Mirvis SE, Panacek EA, et al. Variability in computed tomography and magnetic resonance imaging in patients with cervical spine injuries. J Trauma 2002;53:524-529; discussion 530.
39. Mazonakis M, Tzedakis A, Damilakis J, Gourtsoyiannis N. Thyroid dose from common head and neck CT examinations in children: is there an excess risk for thyroid cancer induction? Eur Radiol 2007;17:1352-1357.
40. Pang D, Wilberger JE. Spinal cord injury without radiographic abnormalities in children. J Neurosurg 1982;57:114-129.
41. Liao C-C, Lui T-N, Chen L-R, et al. Spinal cord injury without radiological abnormality in preschool-aged children: correlation of magnetic resonance imaging findings with neurological outcomes. J Neurosurg 2005;103(Suppl 1):17-23.
42. Launay F, Leet AI, Sponseller PD. Pediatric spinal cord injury without radiographic abnormality: a meta-analysis. Clin Orthop Relat Res 2005:166-170.
43. Schellenberg M, Islam O, Pokrupa R. Traumatic spinal cord injury without initial MRI abnormality: SCIWORA revisited. Can J Neurol Sci 2011;38:364-366.
44. Ackland HM, Cooper DJ, Cooper JD, et al. Factors predicting cervical collarrelated decubitus ulceration in major trauma patients. Spine 2007;32:423-428. http://www.ncbi.nlm.nih.gov/pubmed/17304132. [Accessed 30 November 2011]
45. Schoenfeld AJ, Bono CM, McGuire KJ, et al. Computed tomography alone versus computed tomography and magnetic resonance imaging in the identification of occult injuries to the cervical spine: a meta-analysis. J Trauma 2010;68:109-113; discussion 113-114. This is a meta-analysis comparing CT with the combination of CT and MRI in the evaluation of blunt CSI.
46. Stassen NA, Williams VA, Gestring ML, et al. Magnetic resonance imaging in combination with helical computed tomography provides a safe and efficient method of cervical spine clearance in the obtunded trauma patient. J Trauma 2006;60:171-177.
47. Flynn JM, Closkey RF, Mahboubi S, Dormans JP. Role of magnetic resonance imaging in the assessment of pediatric cervical spine injuries. J Pediatr Orthop; 22:573-577.