Radiography of cervical spine injury in children: Are flexion-extension radiographs useful for acute trauma?

被引:39
作者
Dwek, JR
Chung, CB
机构
[1] Childrens Hosp, Childrens Radiol Inst, Columbus, OH 43205 USA
[2] Univ Calif San Diego, Div Osteoradiol, La Jolla, CA 92161 USA
关键词
D O I
10.2214/ajr.174.6.1741617
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. We assessed the role of cervical spine flexion-extension radiographs in the acute evaluation of pediatric trauma patients. MATERIAL AND METHODS. We performed a retrospective review of all pediatric trauma patients who underwent static cervical spine radiography followed by flexion-extension radiography during a 22-month period. We reviewed the mechanism of injury, physical examination findings, and patient age, and tabulated the results of initial and follow-up imaging studies. RESULTS. Two hundred forty seven children (age range, 1.6-18 years; mean age, 11.5 years) with a history of trauma underwent cervical spine radiography followed by flexion-extension radiography. Static cervical spine radiographs revealed normal findings in 224 patients (91%). Flexion-extension radiographs revealed normal findings for all patients with normal findings on cervical spine radiographs. Of 23 children (9%) with abnormal findings on static cervical spine radiographs, seven (30%) had congenital abnormalities visible on flexion-extension radiographs; 10 (43%) had traumatic injuries including fracture, subluxation, or soft-tissue swelling; two (9%) had instability; and six (26%) had questionable abnormalities that were noted on static cervical spine radiographs. In four patients (66%) with abnormal findings on static cervical spine radiographs, flexion-extension radiographs were helpful in ruling out abnormality. CONCLUSION. In children with a history of trauma and normal findings on static cervical spine radiographs, additional flexion-extension radiographs are of questionable use.
引用
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页码:1617 / 1619
页数:3
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