AN EVALUATION OF THE NECESSITY OF COMPUTED TOMOGRAPHY USED FOR THE CERVICAL SPINE ASSESSMENT OF THE PATIENTS WHO PRESENT WITH TRAUMA IN THE PEDIATRIC EMERGENCY DEPARTMENT

Abstract

Objective: Cervical spine trauma in children is rare and its diagnosis can be challenging as compared to adults due to anatomical and biomechanical modifications. The purpose of this study was to assess the effectiveness of computed tomography (CT) of the cervical spine in pediatric patients with suspected cervical spine injury in addition to radiography. Material and Method: One hundred sixty seven pediatric patients (aged 3 months to 14 years) who were treated in our pediatric emergency department during of January 2010-June 2011 due to cervical trauma and who had radiographs and CTs taken were evaluated. All patients underwent cervical examination and radiological evaluation in the same order Radiographs and CTs were evaluated for the presence of fractures, subluxations, and dislocations. Results: Eight patients with negative radiography findings were found to have positive CT findings. One patient was found to have atlantoaxial rotatory subluxation; one had odontoid fracture, one had vertebral body wedge fracture, one had posterior arch fracture dislocation, one had 0-C1 subluxation or dislocation, one had C1 ring fracture, and one had vinous process fracture. Conclusion: In order not to miss possible injuries in pediatric cervical trauma patients, whose cervical vertebra examination is positive it is necessary to get CT scan even if the plain radiography result is negative.