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Imaging, Clearance, and Controversies in Pediatric Cervical Spine Trauma

Tat, Sonny T. MD, MPH*†; Mejia, Michelle J. MD; Freishtat, Robert J. MD, MPH*†§

doi: 10.1097/PEC.0000000000000298
CME Review Article

Diagnosing cervical spine injury in children can be difficult because the clinical examination can be unreliable, and evidence-based consensus guidelines for cervical spine injury evaluation in children have not been established. However, the consequences of cervical spine injuries are significant. Therefore, practitioners should understand common patterns of cervical spine injury in children, the evidence and indications for cervical spine imaging, and which imaging modalities to use. Herein, we review the epidemiology and unique anatomical features of pediatric cervical spine injury. In addition, we will summarize current practice for clearance and imaging of the pediatric cervical spine in trauma.

Emergency Medicine Fellow (Tat), Associate Professor (Freishtat), *Division of Emergency Medicine, Children’s National Medical Center, Washington, DC; Pediatrics Fellow (Tat), Associate Professor (Freishtat), †Department of Pediatrics, George Washington University School of Medicine and Health Sciences; Georgetown University Student (Mejia), ‡Georgetown University School of Medicine; and Associate Professor (Freishtat), §Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.

The authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Reprints: Robert J. Freishtat, MD, MPH, Division of Emergency Medicine, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010 (e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.