Can we do less? A review of imaging practices for evaluating cervical spine injuries in pediatric blunt trauma patients.

Humza Thobani, Cody Dalton, Kathleen R Ehresmann, Shawn Larson, Faraz A Khan, Saleem Islam

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Humza ThobaniDivision of Pediatric Surgery, Department of Surgery, Stanford University, Palo Alto, CA, USA.

Cody DaltonDivision of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, PO Box 100119, Gainesville, FL, 32610-0119, USA.

Kathleen R EhresmannDivision of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, PO Box 100119, Gainesville, FL, 32610-0119, USA.

Shawn LarsonDivision of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, PO Box 100119, Gainesville, FL, 32610-0119, USA.

Faraz A KhanDivision of Pediatric Surgery, Department of Surgery, Stanford University, Palo Alto, CA, USA.

Saleem IslamSection of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan. saleem.islam@surgery.ufl.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to investigate whether a validated clinical decision tool or other clinical features at presentation could predict cervical spine injury in a cohort of children who were selected for cervical spine imaging following blunt trauma.

methodsWe conducted a retrospective review of all patients < 18 years presenting to our institution with blunt trauma who underwent cervical spine imaging over a 3-year period. Relevant data on patients' clinical presentation, imaging, management and outcomes were compiled. The NEXUS screening tool was retroactively applied to all patients. Univariable and multivariable logistic regression was conducted to identify independent predictors of CSI.

results1,321 patients presented with blunt trauma, out of which 484 underwent cervical spine imaging and were included in our study. Computerized tomography (CT) scans were conducted in most patients (n = 447, 92.4%). NEXUS risk stratification failed to identify 9 CSIs and had an overall sensitivity of 80.4%. Out of all the possible risk factors we investigated, only chest/torso trauma was found to be significantly associated with CSI on multivariate regression.

conclusionWe were unable to identify a screening tool or predictive model which could be used to further reduce imaging practices at our institution without missing clinically significant CSIs.

Indexed as

Cervical VertebraeSpinal InjuriesTomography, X-Ray ComputedWounds, NonpenetratingAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective Studies

Identifiers

PMID40425891

DOI10.1007/s00383-025-06053-3

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.