Normal variants in young children <8 years of age, such as pseudosubluxation of C2-C3, absence of lordosis, C3 vertebral wedged appearance, widening of the atlantodental interval, prevertebral soft-tissue thickening, Young children and those with developmental delays may require sedation in order to obtain adequate CT and MR images. The risks of sedation should be balanced against the benefit of a CT, particularly when radiographs are normal [19]. MRI Cervical Spine MRI is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). Arteriography Cervicocerebral Cervicocerebral arteriography is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). US Cervical Spine Ultrasound (US) is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). CT Myelography Cervical Spine Myelography is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). For suspected ligamentous injury in conscious children, it was shown that cervical flexion and extension views in children and adults with acute blunt cervical trauma are unlikely to yield additional results [36,38-41] and are rarely needed in children [42]. Neck pain and muscle spasm may limit spinal motion of flexion and extension views in the acute setting and prevent the diagnosis of ligamentous injury from being made [34]. CT Cervical Spine CT cervical spine may be of value as a follow-up examination in patients who had radiographs with abnormal or ambiguous findings. The strengths of CT without intravenous (IV) contrast include its superior visualization of bony detail and ability to differentiate congenital variants from traumatic injuries.
Suspected Spine Trauma Child PCAs. Normal variants in young children <8 years of age, such as pseudosubluxation of C2-C3, absence of lordosis, C3 vertebral wedged appearance, widening of the atlantodental interval, prevertebral soft-tissue thickening, Young children and those with developmental delays may require sedation in order to obtain adequate CT and MR images. The risks of sedation should be balanced against the benefit of a CT, particularly when radiographs are normal [19]. MRI Cervical Spine MRI is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). Arteriography Cervicocerebral Cervicocerebral arteriography is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). US Cervical Spine Ultrasound (US) is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). CT Myelography Cervical Spine Myelography is not routinely used in the evaluation of suspected pediatric spine trauma in the absence of risk factors (based on PECARN or NEXUS in Appendix 1). For suspected ligamentous injury in conscious children, it was shown that cervical flexion and extension views in children and adults with acute blunt cervical trauma are unlikely to yield additional results [36,38-41] and are rarely needed in children [42]. Neck pain and muscle spasm may limit spinal motion of flexion and extension views in the acute setting and prevent the diagnosis of ligamentous injury from being made [34]. CT Cervical Spine CT cervical spine may be of value as a follow-up examination in patients who had radiographs with abnormal or ambiguous findings. The strengths of CT without intravenous (IV) contrast include its superior visualization of bony detail and ability to differentiate congenital variants from traumatic injuries.