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Hot Topic 1: Risk Factors for Cervical Spine Injury

Review: (F. Bullaro) Retrospective chart review of pediatric trauma patients with cervical spine injury on CT imaging. Three risk factors were identified as significant for cervical spine injury including male gender, higher ISS and neck tenderness.

Identification of Risk Factors for Cervical Spine Injury from Pediatric Trauma Registry
Chaudhry A.S., Prince J., Sorrentino C., Fasanya C., McGinn J., Atanassov K.D., Bloom S., Price M.
Pediatr Neurosurg. 2016;51(4):167-74

Abstract
Objectives: 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.