Document Detail

Role of flexion-extension radiographs in blunt pediatric cervical spine injury.
MedLine Citation:
PMID:  11229945     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether flexion-extension cervical spine radiography (FECSR) is abnormal in children who have sustained blunt cervical spine injury (CSI) when standard cervical spine radiography (SCSR) demonstrates no acute abnormalities. METHODS: This was a blinded radiographic review of 129 patients < or = 16 years of age evaluated at an academic pediatric trauma center during July 1990-March 1996. All patients had SCSR (anteroposterior/lateral views) and FECSR performed for a trauma-related event within seven days of injury. RESULTS: Of 46 patients without acute abnormalities on SCSR, one patient (with final clinical diagnosis of "no CSI") had acute abnormalities on FECSR (95% CI = 0.06% to 11.5%). Of 50 patients with isolated loss of lordosis on SCSR, no patient had acute abnormalities on FECSR (95% CI = 0% to 5.8%). The FECSR review revealed no acute abnormalities in 75 of 83 patients (90.4%) with suspicious findings for CSI viewed on SCSR (95% CI = 81.9% to 95.7%). Complications during FECSR were noted in one patient with transient paresthesias (0.8%) (95% CI = 0.02% to 4.2%). CONCLUSIONS: In children who underwent acute radiographic evaluation of blunt cervical spine trauma, FECSR was unlikely to be abnormal when no acute abnormality or isolated loss of lordosis was evident on SCSR. In a subset of patients with suspicious findings for occult CSI on SCSR, FECSR was useful in ruling out ligamentous instability in the acute, posttrauma setting.
M E Ralston; K Chung; P D Barnes; J B Emans; S A Schutzman
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  8     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-20     Completed Date:  2001-05-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-45     Citation Subset:  IM    
Departments of Medicine, Division of Emergency Medicine, Children's Hospital, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Cervical Vertebrae / injuries*,  radiography*
Child, Preschool
Double-Blind Method
Spinal Injuries / radiography*
Wounds, Nonpenetrating / radiography*

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