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Identification of Risk Factors for Cervical Spine Injury from Pediatric Trauma Registry
Aisha S Chaudhry1, Jose Prince, Christopher Sorrentino
1Staten Island University Hospital, Staten Island, N.Y., USA.
Insights
Pediatric cervical spine injuries are rare. Male gender, severe injury (higher Injury Severity Score), and neck tenderness are key indicators for potential cervical spine injury in children, guiding imaging decisions.
Area of Science:
- Pediatric Traumatology
- Radiology
- Orthopedic Surgery
Background:
- Cervical spine injuries are infrequent in pediatric trauma cases.
- Current imaging practices may lead to unnecessary radiation exposure in children.
- Developing evidence-based guidelines is crucial for pediatric cervical spine clearance.
Purpose of the Study:
- To establish practical guidelines for cervical spine clearance in pediatric patients.
- To minimize radiation exposure by reducing unnecessary advanced imaging.
- To identify predictors of significant cervical spine injury in children.
Main Methods:
- Retrospective review of trauma registries from two pediatric centers (11-year period).
- Evaluation of patients aged 1 month to 17 years undergoing cervical spine CT for trauma.
- Statistical analysis to identify significant risk factors for cervical spine injury.
Main Results:
- Male gender was significantly associated with cervical spine injury (p = 0.0261).
- Higher Injury Severity Score (ISS) indicated more severe trauma in injured patients (16.39 vs. 8.7).
- Neck tenderness was a strong predictor of cervical spine injury (p = 0.0001).
Conclusions:
- Significant cervical spine injury in children is linked to male gender.
- Higher ISS and the presence of neck tenderness are critical indicators.
- Findings support refined guidelines for pediatric cervical spine clearance and imaging.
Background:
Cervical spine injuries are rare in children. Our goal is to establish guidelines for cervical spine clearance that are practical for our pediatric population, and, in the process, to reduce the risk of radiation exposure from unnecessary advanced imaging.
Methods:
We retrospectively reviewed the records from the registries of two pediatric trauma centers from the past 11 years (January 2002 to June 2013). Patients aged 1 month to 17 years, who had a CT scan of the cervical spine due to trauma indication for possible cervical spine injury, were evaluated.
Results:
Three risk factors were identified as being significant for the presence of a cervical spine injury. Patients who sustained a cervical spine injury were more likely to be male (p = 0.0261), were more severely injured with a higher injury severity score (ISS 16.39 ± 15.79 injured vs. 8.7 ± 9.4 uninjured), and presented with neck tenderness (p = 0.0001).
Conclusion:
In our study, significant cervical spine injury is related to male gender, higher ISS and neck tenderness.
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