Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    

Users Online: 900 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Year : 2018  |  Volume : 52  |  Issue : 5  |  Page : 489-500

Cervical spine evaluation in pediatric trauma: A review and an update of current concepts

1 Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
3 Department of Pediatric Orthopedics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA

Correspondence Address:
Dr. Vibhu Krishnan Viswanathan
Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio 43202
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_607_17

Rights and Permissions

The clinical presentation and diagnostic workup in pediatric cervical spine injuries (CSI) are different from adults owing to the unique anatomy and relative immaturity. The current article reviews the existing literature regarding the uniqueness of these injuries and discusses the current guidelines of radiological evaluation. A PubMed search was conducted using keywords “paediatric cervical spine injuries” or “paediatric cervical spine trauma.” Six hundred and ninety two articles were available in total. Three hundred and forty three articles were considered for the review after eliminating unrelated and duplicate articles. Further screening was performed and 67 articles (original articles and review articles only) related to pediatric CSI were finally included. All articles were reviewed for details regarding epidemiology, injury patterns, anatomic considerations, clinical, and radiological evaluation protocols. CSIs are the most common level (60%–80%) for pediatric Spinal Injuries (SI). Children suffer from atlantoaxial injuries 2.5 times more often than adults. Children's unique anatomical features (large head size and highly flexible spine) predispose them to such a peculiar presentation. The role of National Emergency X-Ray Utilization Study, United State (NEXUS) and Canadian Cervical Spine Rule criteria in excluding pediatric cervical injury is questionable but cannot be ruled out completely. The minimum radiological examination includes 2- or 3-view cervical X-rays (anteroposterior, lateral ± open-mouth odontoid views). Additional radiological evaluations, including computerized tomography (CT) and magnetic resonance imaging (MRI) are obtained in situations of abnormal physical examination, abnormal X-rays, inability to obtain adequate X-rays, or to assess cord/soft-tissue status. The clinical criteria for cervical spine injury clearance can generally be applied to children older than 2 years of age. Nevertheless, adequate caution should be exercised before applying these rules in younger children. Initial radiographic investigation should be always adequate plain radiographs of cervical spine. CT and MRI scans should only be performed in an appropriate group of pediatric patients.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded92    
    Comments [Add]    

Recommend this journal