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Pediatric spine trauma: A comprehensive review
Devanshi Mistry1, Havisha Munjal2, Shehanaz Ellika1
1University of Rochester Department of Imaging Sciences, Rochester, NY, USA.
Insights
Pediatric spine trauma presents unique challenges for diagnosis due to developmental variations. This review offers radiologists a comprehensive guide to imaging protocols and interpretation for pediatric spinal injuries.
Area of Science:
- Radiology
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Pediatric spine trauma has higher mortality and distinct injury patterns compared to adults.
- Interpreting pediatric spine radiographs is difficult due to partially ossified structures and developmental variations.
- Existing literature often lacks a radiologist-specific focus on pediatric spine trauma.
Purpose of the Study:
- To provide a comprehensive review of pediatric spine trauma tailored for radiologists.
- To address the gap in literature regarding effective imaging and interpretation of pediatric spinal injuries.
Main Methods:
- Review of clinical decision tools and imaging protocols, including American College of Radiology (ACR) guidelines.
- Detailed discussion of common pediatric spine injury patterns, diagnostic pitfalls, and management implications.
- Inclusion of tables, illustrations, and imaging examples to reinforce key concepts.
Main Results:
- Highlights the challenges in diagnosing pediatric spine trauma, including osseous, disco-ligamentous, and neurological injuries.
- Emphasizes the importance of understanding developmental anatomy and imaging pitfalls.
- Provides actionable tips for effective performance and interpretation of imaging exams.
Conclusions:
- A comprehensive, radiologist-focused approach is crucial for accurate diagnosis and management of pediatric spine trauma.
- Understanding specific pediatric imaging nuances and pitfalls improves diagnostic accuracy.
- This review serves as a valuable resource for radiologists managing pediatric spinal injuries.
Abstract:
Trauma to the pediatric spine can manifest as osseous, disco-ligamentous, and/or neurological injuries. Associated mortality is significantly higher than in adults. Injury patterns in children are distinct from those encountered in adults. Although spine radiographs are the first line of diagnosis, they may be challenging to interpret in children due to the difficulty of applying recognized radiographic landmarks to the partially ossified spine. Ligamentous laxity and developmental phenomena also lead to imaging pitfalls. Much of the recent literature on this subject focuses on region-specific injuries or individual entities, and may not be tailored specifically to the radiologist, thereby not stressing key aspects pertinent to the effective performance and successful interpretation of imaging exams. We aim to address this void. We provide a comprehensive review of pediatric spine trauma, outlining the clinical decision tools, imaging protocols including the current American College of Radiology (ACR) appropriateness guidelines, interpretive pitfalls and tips to navigate these pitfalls, and management implications of the spectrum of these injuries. Throughout the text, extensive tables, illustrations and imaging examples reinforce key concepts.
