Clinical Clearance of the Cervical Spine in Blunt Trauma Patients Younger than 3 Years: a Multi-Center Study of the American Association for the Surgery of Trauma.

Publication/Presentation Date

9-1-2009

Abstract

BACKGROUND: Cervical spine clearance in the very young child is challenging. Radiographic imaging to diagnose cervical spine injuries (CSI) even in the absence of clinical findings is common, raising concerns about radiation exposure and imaging-related complications. We examined whether simple clinical criteria can be used to safely rule out CSI in patients younger than 3 years.

METHODS: The trauma registries from 22 level I or II trauma centers were reviewed for the 10-year period (January 1995 to January 2005). Blunt trauma patients younger than 3 years were identified. The measured outcome was CSI. Independent predictors of CSI were identified by univariate and multivariate analysis. A weighted score was calculated by assigning 1, 2, or 3 points to each independent predictor according to its magnitude of effect. The score was established on two thirds of the population and validated using the remaining one third.

RESULTS: Of 12,537 patients younger than 3 years, CSI was identified in 83 patients (0.66%), eight had spinal cord injury. Four independent predictors of CSI were identified: Glasgow Coma Score

CONCLUSIONS: CSI in patients younger than 3 years is uncommon. Four simple clinical predictors can be used in conjunction to the physical examination to substantially reduce the use of radiographic imaging in this patient population.

Volume

67

Issue

3

First Page

543

Last Page

549

ISSN

1529-8809

Disciplines

Other Medical Specialties | Surgery

PubMedID

19741398

Peer Reviewed for front end display

Peer-Reviewed

Department(s)

Department of Education, Medical Education, Department of Surgery, USF-LVHN SELECT Program, USF-LVHN SELECT Program Faculty

Document Type

Article

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