Document Detail


Cervical spine evaluation in obtunded or comatose pediatric trauma patients: A pilot study.
MedLine Citation:
PMID:  10420124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A uniformly accepted protocol for evaluation and clearance of the cervical spine of pediatric trauma patients with altered mental status does not currently exist. We sought to detect cervical spine injuries in this group with minimal risk. Patients were evaluated with standard three-view cervical spine radiographs and CT when necessary. Those patients without radiographic abnormality and altered mental status underwent flexion-extension of the cervical spine using fluoroscopy with somatosensory evoked potential (SSEP) monitoring. Those with abnormal movement by fluoroscopy or changes in SSEP underwent MRI. Fifteen patients were evaluated with this protocol. Two patients had movement on flexion-extension of the cervical spine and 5 had SSEP changes. Three patients had an MRI with only 1 showing injury. Five patients had residual hemiparesis. Evaluation of the cervical spine in obtunded or comatose pediatric trauma patients can be done safely with flexion-extension under fluoroscopy and SSEP monitoring. Further prospective studies are required to determine the efficacy of SSEP monitoring for cervical spine clearance in this select population.
Authors:
A M Scarrow; E I Levy; D K Resnick; P D Adelson; R J Sclabassi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  30     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-08-20     Completed Date:  1999-08-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  169-75     Citation Subset:  IM    
Affiliation:
University of Pittsburgh School of Medicine, Department of Neurosurgery and the Center for Clinical Neurophysiology, Children's Hospital of Pittsburgh and UPMC Presbyterian Hospital, Pittsburgh, PA 15213-2582, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cervical Vertebrae / injuries*,  physiopathology,  radiography
Child
Child, Preschool
Clinical Protocols
Craniocerebral Trauma / complications*
Evoked Potentials, Somatosensory
Female
Fluoroscopy / methods
Follow-Up Studies
Humans
Infant
Magnetic Resonance Imaging
Male
Median Nerve / physiopathology
Movement
Pilot Projects
Spinal Cord Injuries / etiology,  prevention & control*
Spinal Injuries / complications,  diagnosis*,  physiopathology
Unconsciousness* / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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