Blunt cervical spine injury in children
Current Opinion in Pediatrics, 05/15/2012
Tilt L et al. – Evidence in the management of children with cervical spine injury (CSI) has expanded in recent years, but further large prospective studies are needed. The authors present a review of some recent developments influencing clinical practice.Methods
- The authors present data from recently conducted research regarding the diagnosis of blunt cervical spine injury (CSI) in children.
- Research in the prehospital setting to evaluate the need for cervical spine immobilization in children, regardless of clinical findings or mechanism of injury, suggests that low-risk prediction rules may be safely utilized by prehospital providers, although more data is needed.
- Their size, developing skeleton and unique anatomy leave children vulnerable to particular injury patterns, namely cephalad bony fractures and ligamentous and spinal cord injuries without radiographic abnormality.
- Low-risk clinical prediction rules have been developed but need to be further validated.
- For those children at higher risk of CSI, diagnostic imaging strategies are evolving, with computed tomography and MRI becoming more prominent.