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Emergent Imaging of Pediatric Cervical Spine Trauma

Aaron S McAllister1, Usha Nagaraj1, Rupa Radhakrishnan1

  • 1From the Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205, and Department of Radiology, The Ohio State University, Columbus, Ohio (A.S.M.); Department of Radiology and Medical Imaging, Cincinnati Children's Hospital, Cincinnati, Ohio (U.N.); and Department of Radiology and Imaging Sciences, Riley Hospital for Children at Indiana University Health, Indianapolis, Ind (R.R.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|June 8, 2019
PubMed

Insights

Pediatric spinal injuries differ from adult injuries due to unique physiology and biomechanics. Early MRI is crucial for diagnosing severe pediatric cervical spine injuries, including craniocervical junction injuries.

Area of Science:

  • Pediatric Radiology
  • Orthopedic Surgery
  • Trauma Surgery

Background:

  • Pediatric spinal injuries present distinct incidence, patterns, and mechanisms compared to adults.
  • Unique factors in children, such as synchondroses and developmental variants, complicate spinal evaluation.
  • Despite lower incidence, pediatric spinal injuries carry more severe sequelae, including higher morbidity and mortality.

Purpose of the Study:

  • To review common pediatric cervical spine injury patterns.
  • To highlight differences in pediatric versus adult spinal injuries.
  • To emphasize key diagnostic imaging considerations for pediatric spinal trauma.

Main Methods:

  • Review of pediatric cervical spine injury patterns.
  • Discussion of unique pediatric physiologic and biomechanical factors.
  • Emphasis on imaging assessment, particularly MRI at the craniocervical junction.

Main Results:

  • Pediatric spinal injuries occur at higher levels (craniocervical junction to C3) due to head size and ligamentous laxity.
  • Nonaccidental trauma is a significant mechanism in infants and toddlers.
  • Spinal cord injury without radiographic abnormality is a recognized entity.

Conclusions:

  • Pediatric spinal injuries require specialized evaluation due to unique characteristics.
  • Prompt assessment of spinal alignment and soft tissues, especially with MRI, is vital.
  • Understanding specific pediatric injury patterns, like craniocervical junction injuries, improves diagnosis and management.

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