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ALBUQUERQUE — Computed tomography imaging with coronal and sagittal reconstructions beat conventional x-rays at diagnosing cervical spine injuries in high-risk pediatric trauma patients in a study.
Dr. Gregory A. Mencio of Vanderbilt University in Nashville, Tenn., reviewed 413 consecutive charts of high-risk patients younger than 18 years at a level I trauma center. All were evaluated by CT scan and conventional five-view x-ray of the cervical spine.
CT scanning detected 71 of 74 cervical spine injuries in the patients, who had an average age of 11 years. Only 50 injuries were detected by x-ray. Combining the two brought the detection rate to 72 cases—just 1 more than diagnosed by CT, Dr. Mencio said at the annual meeting of the Pediatric Orthopaedic Society of North America.
“A lot of these kids have multiple systems injury,” Dr. Mencio said. “Do a CT of the head and neck and torso and total spine. It takes about 10 minutes to scan them from top to bottom, and you have all the information that you need.”
The researchers estimated that the radiation dose was lower with CT, but the costs were higher: $1,800 for CT, vs. $500 for x-rays. For both, Dr. Mencio noted conflicting data appear in the literature.
He offered these recommendations:
▸ CT of the cervical spine with sagittal and coronal reconstructions is the initial imaging modality of choice for high-risk pediatric trauma patients.
▸ Conventional x-ray may be used to elucidate dynamic instability and follow alignment over time.
▸ Magnetic resonance imaging is used to evaluate patients with neurologic injuries and in obtunded patients who risk prolonged immobilization.
ALBUQUERQUE — Computed tomography imaging with coronal and sagittal reconstructions beat conventional x-rays at diagnosing cervical spine injuries in high-risk pediatric trauma patients in a study.
Dr. Gregory A. Mencio of Vanderbilt University in Nashville, Tenn., reviewed 413 consecutive charts of high-risk patients younger than 18 years at a level I trauma center. All were evaluated by CT scan and conventional five-view x-ray of the cervical spine.
CT scanning detected 71 of 74 cervical spine injuries in the patients, who had an average age of 11 years. Only 50 injuries were detected by x-ray. Combining the two brought the detection rate to 72 cases—just 1 more than diagnosed by CT, Dr. Mencio said at the annual meeting of the Pediatric Orthopaedic Society of North America.
“A lot of these kids have multiple systems injury,” Dr. Mencio said. “Do a CT of the head and neck and torso and total spine. It takes about 10 minutes to scan them from top to bottom, and you have all the information that you need.”
The researchers estimated that the radiation dose was lower with CT, but the costs were higher: $1,800 for CT, vs. $500 for x-rays. For both, Dr. Mencio noted conflicting data appear in the literature.
He offered these recommendations:
▸ CT of the cervical spine with sagittal and coronal reconstructions is the initial imaging modality of choice for high-risk pediatric trauma patients.
▸ Conventional x-ray may be used to elucidate dynamic instability and follow alignment over time.
▸ Magnetic resonance imaging is used to evaluate patients with neurologic injuries and in obtunded patients who risk prolonged immobilization.
ALBUQUERQUE — Computed tomography imaging with coronal and sagittal reconstructions beat conventional x-rays at diagnosing cervical spine injuries in high-risk pediatric trauma patients in a study.
Dr. Gregory A. Mencio of Vanderbilt University in Nashville, Tenn., reviewed 413 consecutive charts of high-risk patients younger than 18 years at a level I trauma center. All were evaluated by CT scan and conventional five-view x-ray of the cervical spine.
CT scanning detected 71 of 74 cervical spine injuries in the patients, who had an average age of 11 years. Only 50 injuries were detected by x-ray. Combining the two brought the detection rate to 72 cases—just 1 more than diagnosed by CT, Dr. Mencio said at the annual meeting of the Pediatric Orthopaedic Society of North America.
“A lot of these kids have multiple systems injury,” Dr. Mencio said. “Do a CT of the head and neck and torso and total spine. It takes about 10 minutes to scan them from top to bottom, and you have all the information that you need.”
The researchers estimated that the radiation dose was lower with CT, but the costs were higher: $1,800 for CT, vs. $500 for x-rays. For both, Dr. Mencio noted conflicting data appear in the literature.
He offered these recommendations:
▸ CT of the cervical spine with sagittal and coronal reconstructions is the initial imaging modality of choice for high-risk pediatric trauma patients.
▸ Conventional x-ray may be used to elucidate dynamic instability and follow alignment over time.
▸ Magnetic resonance imaging is used to evaluate patients with neurologic injuries and in obtunded patients who risk prolonged immobilization.