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Investigators evaluated the sensitivity of plain radiographs of the cervical spine (two or more views) for identifying bony or ligamentous injury in a retrospective cohort of children <16 years with blunt cervical spine injury at 17 hospitals between 2000 and 2004. Patients with atlantoaxial rotary subluxation or spinal cord injury without evidence of radiologic abnormalities were excluded.
Of 206 patients (mean age, 12.7 years), 36% required neurosurgical intervention, 20% had persistent neurologic deficits, and 3% died. Plain radiographs identified 82% of injuries in all patients and 90% of injuries in the 186 patients with adequate views. Of 18 patients with adequate views that did not identify injury, 9 had at least one of the following …