STUDY OBJECTIVE Although many adult algorithms for evaluating cervical spine injury use computed tomography (CT) as the initial screening modality, this may not be appropriate in low-risk children, considering radiation risks. We determine the optimal initial evaluation strategy for cervical spine injury in pediatric blunt trauma. METHODS We constructed a decision analysis tree for a hypothet...

Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma.

A 59 year old man was found collapsed and unconscious, tracheal intubation was performed without immobilisation of the cervical spine. Examination revealed signs of spinal cord transection with quadraplegia and a lateral cervical spine radiograph showed a displaced fracture of the odontoid peg. This case reinforces the importance of appropriate cervical spine management in all victims of trauma...

Injuries to the cervical spine occur in approximately 4% of trauma patients, including 8% of patientswho are unconscious or obtunded, and 3% of alert trauma presentations. Failure in detecting cervical spine injury in an efficient and timely manner in the acute clinical setting can result in catastrophic consequences involving permanent neurologic sequelae. As a result, clinical assessment and ...

Question: Does implementation of the Canadian C-spine rule in emergency departments reduce the proportion of patients referred for diagnostic imaging of the cervical spine without a concurrent increase in unidentified cervical spine injuries or serious adverse outcomes? Design: Matched pair cluster randomised trial. Setting: 12 emergency departments of teaching and community hospitals in Canada...

BACKGROUND Correct diagnosis of cervical spine injuries is still a common problem in traumatology. The incidence of delayed diagnosis ranges from 5 to 20%. The aim of this study was to analyze the frequency and reasons for delayed or missed diagnosis at this Level I trauma unit and to provide recommendations for optimal examination of patients with suspected cervical spine injuries. METHODS A...

Injuries to the cervical spine occur in 2.0 to 6.6% of blunt trauma patients, with the co-existence of head injury increasing the incidence of cervical spine injury to 10%. Injury to the cervical spinal cord in the absence of fracture occurs in 0.07 to 0.7% of trauma admissions. Missed or delayed diagnosis of cervical spine injury occurs in 4 to 8% of patients, whereas for the whole spine, miss...

The importance of visualizing the entire cervical spine on radiological examination in patients with cervical trauma is well known. A review of the cervical films of 98 patients attending an accident and emergency (A&E) department was undertaken in order to assess the adequacy of imaging. It was found that 33.7% of the films were not sufficient to exclude fracture or dislocation of the cervical...