New Rule for C-Spine Imaging in Children Younger Than 3 Years

Approximately two thirds of patients could have forgone imaging if the rule had been applied.

Cervical spine injury is uncommon in toddlers, but clinical clearance is purported to be unreliable in this age group. The NEXUS and Canadian C-Spine Rule studies included too few infants and toddlers to render either decision rule valid in these age groups. These authors studied data from 22 level I or II trauma centers in the U.S., Canada, and Brazil during a 10-year period to identify clinical criteria that could be used to exclude C-spine injury in infants and toddlers.

Of 12,537 blunt-trauma patients younger than 3 years, 83 (0.66%) had C-spine injury (bony or ligamentous). In multivariate analysis, the authors identified four independent predictors of C-spine injury and assigned points for each based on effect size: 3 points for Glasgo…

Reviewing Author

John A. Marx, MD, FAAEM