Targeted Imaging Is the Best Approach for Pediatric Cervical Spine Evaluation

Investigators determined the optimal strategy for evaluating cervical spine injuries in children with blunt trauma, taking into account risks for cervical spine injury and radiation-induced malignancy. They used data from the National Emergency X-radiography Utilization Study (NEXUS) and the Pediatric Emergency Care Applied Research Network (PECARN) to construct decision analysis trees; the models assumed a baseline risk of cervical spine injury of 0.98% for all patients and 1.22% for NEXUS-positive patients, and an average probability of malignancy of 40/10,000 cervical computed tomography (CT) scans.

In a hypothetical pediatric population (age <19 years) presenting with blunt trauma, the preferred management strategy was clinical clearance…