Role of magnetic resonance imaging in the assessment of pediatric cervical spine injuries

The purpose of this study was to determine the role of magnetic resonance imaging (MRI) in the evaluation of children with suspected cervical spine injury (CSI). The authors studied 237 consecutive children, 74 of whom were evaluated by MRI based on a trauma protocol of the authors' institution. The criteria for MRI were: (1) an obtunded or nonverbal child suspected of having CSI, (2) equivocal plain films, (3) neurologic symptoms without radiographic findings, or (4) an inability to clear the cervical spine within 3 days, based on testing. The average age of the evaluated children was 8 years. MRI confirmed the plain radiography diagnosis in 66% of children and altered the diagnosis in 34%. MRI is valuable in the evaluation of potential CS, especially in obtunded children or children with equivocal plain radiographs.