Cervical spine injuries to children under 11: Should we use radiography more selectively in their initial assessment?

Abstract

Objectives: To assess the effectiveness of cervical spine radiography in injured children under 11 years old, and suggest improvements. Methods: Retrospective survey of radiographs and accident and emergency records for children examined during a one year period in a large teaching hospital. Results: No cervical spine fractures occurred in this age group during the year. The recorded clinical findings did not always justify radiography. Conclusions: Clinical examination appears undervalued by those assessing injured children and is poorly recorded. Radiography can be used more selectively. Initial assessment using a single lateral projection can be followed in doubtful cases by cross sectional imaging.