دورية أكاديمية
أعرض في EDS

Pediatric cervical spine clearance: A 10-year evaluation of multidetector computed tomography at a level 1 pediatric trauma center.

التفاصيل البيبلوغرافية
العنوان: Pediatric cervical spine clearance: A 10-year evaluation of multidetector computed tomography at a level 1 pediatric trauma center.
المؤلفون: Russell KW; From the Division of Pediatric Surgery, Department of Surgery (K.W.R., S.E.I., K.M.S., N.E.P., K.E.L., T.M.B., S.J.F., R.A.S.) and Department of Neurosurgery (R.R.I., D.L.B.), University of Utah, Salt Lake City, Utah; Primary Children's Hospital, Salt Lake City, UT (K.L.B.); and Division of Trauma and Surgical Critical Care, Department of Surgery (K.I.), University of Southern California, Los Angles, CA., Iantorno SE, Iyer RR, Brockmeyer DL, Smith KM, Polukoff NE, Larsen KE, Barnes KL, Bell TM, Fenton SJ, Inaba K, Swendiman RA
المصدر: The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2023 Sep 01; Vol. 95 (3), pp. 354-360. Date of Electronic Publication: 2023 Apr 19.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins
مواضيع طبية MeSH: Wounds, Nonpenetrating*/diagnostic imaging , Spinal Injuries*/diagnostic imaging , Spinal Injuries*/surgery , Neck Injuries*, Humans ; Child ; Adolescent ; Multidetector Computed Tomography ; Prospective Studies ; Retrospective Studies ; Trauma Centers ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/injuries ; Magnetic Resonance Imaging
مستخلص: Introduction: Efficient and accurate evaluation of the pediatric cervical spine (c-spine) for both injury identification and posttraumatic clearance remains a challenge. We aimed to determine the sensitivity of multidetector computed tomography (MDCT) for identification of cervical spine injuries (CSIs) in pediatric blunt trauma patients.
Methods: A retrospective cohort study was conducted at a level 1 pediatric trauma center from 2012 to 2021. All pediatric trauma patients age younger than 18 years who underwent c-spine imaging (plain radiograph, MDCT, and/or magnetic resonance imaging [MRI]) were included. All patients with abnormal MRIs but normal MDCTs were reviewed by a pediatric spine surgeon to assess specific injury characteristics.
Results: A total of 4,477 patients underwent c-spine imaging, and 60 (1.3%) were diagnosed with a clinically significant CSI that required surgery or a halo. These patients were older, more likely to be intubated, have a Glasgow Coma Scale score of <14, and more likely to be transferred in from a referring hospital. One patient with a fracture on radiography and neurologic symptoms got an MRI and no MDCT before operative repair. All other patients who underwent surgery including halo placement for a clinically significant CSI had their injury diagnosed by MDCT, representing a sensitivity of 100%. There were 17 patients with abnormal MRIs and normal MDCTs; none underwent surgery or halo placement. Imaging from these patients was reviewed by a pediatric spine surgeon, and no unstable injuries were identified.
Conclusion: Multidetector computed tomography appears to have 100% sensitivity for detecting clinically significant CSIs in pediatric trauma patients, regardless of age or mental status. Forthcoming prospective data will be useful to confirm these results and inform recommendations for whether pediatric c-spine clearance can be safely performed based on the results of a normal MDCT alone.
Level of Evidence: Diagnostic Tests or Criteria; Level IV.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20230419 Date Completed: 20230824 Latest Revision: 20230828
رمز التحديث: 20231215
DOI: 10.1097/TA.0000000000003929
PMID: 37072884
قاعدة البيانات: MEDLINE
الوصف
تدمد:2163-0763
DOI:10.1097/TA.0000000000003929