The pediatric cervical spine instability study

Abstract

There was a low prevalence of cervical instability in this high-risk group. Plain radiographs, flexion-extension radiographs, and CT all had high sensitivities and specificities. MR imaging had a high false-positive rate, making it sensitive but not specific. The data support using either CT or plain radiographs as the initial cervical spine screening study, but CT is recommended because of its superior ability to detect critical injuries. To definitively rule out ligamentous instability after a negative screening CT scan or cervical spine X-ray, these data support using flexion-extension X-rays with fluoroscopy and not MR imaging.

Pediatric cervical spine clearance: A 10-year evaluation of multidetector computed tomography at a level 1 pediatric trauma center

“…Gargas et al 12 similarly reported zero missed unstable injuries after upgrading their CT scanner in 2005. We have also previously reported on the high sensitivity of MDCT and high rate of false-positive CSIs detected by MRI 20 . The evidence is mounting that MRI does not add value to a normal high-quality MDCT.…”

“…We have also previously reported on the high sensitivity of MDCT and high rate of false-positive CSIs detected by MRI. 20 The evidence is mounting that MRI does not add value to a normal high-quality MDCT.…”

Development of a New Emergency Medicine Spinal Immobilization Protocol for Pediatric Trauma Patients and First Applicability Test on Emergency Medicine Personnel

“…Sports-related accidents are also common causes of pediatric spinal injuries. 2,3,44,47,57,58,64,68,70,71,74,[77][78][79] The occurrence of significant spine injuries from sports increases with age and ability because the speed and size of the athlete correspondingly increases. 65 Because it appears unreasonable to immobilize every child with a sports injury, the E.M.S.…”

Regarding “MR Imaging of the Cervical Spine in Nonaccidental Trauma: A Tertiary Institution Experience”

“…However, there was no blinding for the healthy cohort in the study by Choudhary et al The few studies that have correlated MR imaging findings of lig-amentous signal abnormalities with intraoperative or postmortem findings have found a poor correlation. 5 In a comparison of 4 modalities to assess cervical spine instability in pediatric trauma, Brockmeyer et al 6 found MR imaging to be sensitive but not specific (74%). Because of the low specificity, the authors recommended that MR imaging be performed only in patients with neurologic deficits or to follow up a screening study with positive findings.…”