Pediatric Blunt Cervical Spine Trauma – Current State of Evaluation

The evaluation of the pediatric cervical spine (CS) in blunt trauma patients requires special attention and consideration. The purpose of this article is to review and highlight recent areas of advancement in screening for injury and clearance of the CS.

While attempts have been made to standardize the evaluation of the CS much variation exists in clinical practice between trauma centers. While MRI has been recommended for clearance of the CS in obtunded pediatric patients there is mounting research that demonstrates a high sensitivity of CT scan in identifying clinically significant injuries in this group of patients. And finally, the use of rapid sequence MRI in screening for CS injury is emerging as a potential modality to increase the feasibility of obtaining MRI in critically ill children.

Efforts are needed to create and implement a standardized protocol for CS evaluation, appropriate imaging, and clearance.