Diagnosis of cervical spine injuries in children: a systematic review


The objective of this systematic review was to discuss current knowledge of the diagnostic management of cervical spine (c-spine) injuries in children. Studies dealing with this topic were collected from the following sources: MEDLINE via PubMed, Embase, and Cochrane. Where possible, a meta-analysis was performed. Furthermore, the level of evidence for all the included publications was assigned. The incidence of cervical spine injury (CSI) in children is rare (1.39 %). It seems that the upper c-spine is more often injured in children younger than 8 years of age. When a CSI is expected, immobilization should be performed. The best immobilization is achieved with a combination of a half-spine board, rigid collar, and tape. The literature for thoracic elevation or an occipital recess in children younger than 8 years of age is inhomogeneous. The c-spine in children can be cleared by a combination of the National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria and the Canadian C-Spine Rule. Caution is advised for nonverbal and/or unconscious children. In these children, plain radiographs should be performed. If these images are inadequate or show hints for bony injuries, a computed tomography (CT) of the c-spine should be considered. Additional views of the c-spine offer only little information for clearing the c-spine.

DOI: 10.1007/s00068-013-0295-1

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Cite this paper

@article{Schoeneberg2013DiagnosisOC, title={Diagnosis of cervical spine injuries in children: a systematic review}, author={Carsten Schoeneberg and Bahareh M Schweiger and Bjoern Hussmann and Max Daniel Kauther and Sven Lendemans and Ch. Waydhas}, journal={European Journal of Trauma and Emergency Surgery}, year={2013}, volume={39}, pages={653-665} }