The pediatric trauma C-spine: Is the ‘odontoid’ view necessary?

Buhs, Chad L.; Cullen, Marc L.; Klein, Michael D.; Farmer, Diana L.

doi:10.1053/jpsu.2000.6951

Cited by 100 publications

(43 citation statements)

References 14 publications

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“…In a retrospective review, 10 patients younger than 9 years of age who had sustained a cervical spine injury between the occiput and C-3 were identified, but in none of these cases was the diagnosis based on a transoral odontoid plain x-ray film. 17 In another study that was based on a questionnaire, investigators suggested that children younger than 5 years of age do not require a transoral x-ray film as part of a trauma protocol. 95 At our institution, in children 5 years of age or younger we obtain only AP and lateral plain x-ray films when the trauma protocol has been activated, whereas children older than 5 years also undergo a transoral view.…”

Section: Plain Radiographsmentioning

confidence: 99%

Cervical spine trauma in children: a review

McCall¹,

Fassett²,

Brockmeyer³

2006

FOC

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✓ Injuries of the cervical spine are relatively rare in children but are a distinct clinical entity compared with those found in adults. The unique biomechanics of the pediatric cervical spine lead to a different distribution of injuries and distinct radiographic features. Children younger than 9 years of age usually have upper cervical injuries, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. Pediatric cervical injuries are more frequently ligamentous in nature, and children are also more prone to spinal cord injury without radiographic abnormality than adults are. Physial injuries are specific only to children. Radiographically benign findings, such as pseudosubluxation and synchondrosis, can be mistaken for traumatic injuries. External immobilization with a halo brace can be difficult and is associated with a high complication rate because of the thin calvaria in children. Surgical options have improved with the development of instrumentation specifically for children, but special considerations exist, such as the small size and growth potential of the pediatric spine.

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Section: Plain Radiographsmentioning

confidence: 99%

Cervical spine trauma in children: a review

McCall¹,

Fassett²,

Brockmeyer³

2006

FOC

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“…[1][2][3][4][5][9][10][11] One retrospective study of 227 patients found that of the 38 patients younger than 8 years of age, 87% had an injury at C3 or higher. 11 This is similar to another retrospective study of 408 children who suffered blunt cervical spine injury where they found a significant difference in that younger (less than or equal to 10 years of age) children more often sustained high (C1-C4) versus low (C5-C7) injuries when compare to older children (85.3% versus 56.9%; P < 0.01).…”

Section: Pattern Of Injurymentioning

confidence: 99%

Paediatric cervical spine injuries: An audit of 22 acute injuries and literature review

Watson

Upadhyay

2005

Injury Extra

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“…The probability of cervical spine injury in the NEXUS-positive group was the only independent variable that met a threshold at which an alternate strategy was preferred. At a probability of cervical spine injury in the NEXUS-positive group of 0.03%, which represents a 18 Buhs et al, 20 Mower et al 19 No change Radiograph specificity 95% 60%-100% Streitwieser et al, 22 Nguyen and Clark, 23 Tins and Cassar-Pullicino 24 No change p(malignancy) 0.4% 0.1%-0.7% Berrington de Gonzalez et al 26 No change CSI utility 0.6 0.4-0. 9 Kaplan et al, 29 Oladeji et al, 27 Ravichandran and Silver 28 No change Figure 2.…”

Section: Resultsmentioning

confidence: 99%

“…Additional smaller studies had somewhat lower sensitivities reported, and these data were used in sensitivity analyses. 19,20 Specificity obtained from various trauma literature supported a wide range, from 70% to 95%. [21][22][23][24] We estimated probability of malignancy related to CT radiation exposure from the most recently published data on projected lifetime cancer risk for pediatric patients.…”

Section: Methodsmentioning

confidence: 98%