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Spine Injury: Cervical, Pediatric, Emergency Medicine

Roxanna A. Sadri Reviewed 06/2017
 


Basics

Description

  • Relatively rare, present in 1–2% of patients with severe blunt trauma

  • Children <8 yr of age are more likely to have upper cervical spine injuries (C1–C3) and are at risk of growth ...

Diagnosis

Signs and Symptoms

  • Local cervical spine pain

  • Limited range of motion

  • Neurologic deficit (may be transient)

  • May be masked by altered mental status or distracting injury

  • Abnormal vital signs:

    • Hypote...

Treatment

Pre-Hospital

  • Immobilize all infants and children with potential cervical spine injuries

  • Appropriate size cervical collar

  • Tape, towels, padding in combination with car seat or spine board if for...

Follow-Up

Disposition

Admission Criteria

  • Altered mental status

  • Signs/symptoms of spinal cord injury

  • Fracture

  • Obtain appropriate consultation:

    • Neurosurgery

    • Orthopedic spine

Discharge Criteria

  • Completely normal ...

Pearls and Pitfalls

  • Maintain appropriate immobilization during evaluation.

  • In most cases, plain radiographs can be used as initial screening tool.

  • Be aware of unique features of pediatric cervical spine...

Additional Reading

  • Bracken  MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev.  2012;1:CD001046. doi:10.1002/14651858.CD001046.pub2.

  • Caviness  AC. Evaluation of cervical spine ...

Codes

ICD9

  • 805.00 Closed fracture of cervical vertebra, unspecified level

  • 847.0 Sprain of neck

  • 959.09 Injury of face and neck

  • 952.00 C1-C4 level with unspecified spinal cord injury

  • 728.4 Laxity of ligament

  • ...

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