Cervical spine injury (CSI) in children under 10 years of age is rare and there remains debate around the most common traumatic mechanisms and patterns of injury[1]. Below the age of 10 years, the paediatric cervical spine (c-spine) differs anatomically and physiologically from that of an adult. These differences including incomplete vertebral ossification, lax musculature and ligaments as well as a larger head to body ratio result in much greater c-spine flexibility and are thought to protect against bony injury in blunt trauma[2]. Increased flexibility...

We performed a retrospective study of all patients presenting to the largest NHS trust in the UK between October 2008 and January 2017. We searched the radiology PACS database for all patients who underwent imaging of the cervical spine with X-ray, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) within 12 hours of admission for suspected c-spine injury following blunt trauma. Only patients under the age of 10 at the time of imaging were included. Radiology reports were reviewed for all patients and imaging for...

447 patients under 10 years of age underwent imaging of the c-spine for suspected CSI following blunt trauma during the study period. 7 (1.57% of total) cases of CSI were confirmed in this group, mean age 3.6 years. Of the 7 cases of CSI, 4 were female and 3 were male. All cases of CSI occurred secondary to “high energy trauma”. 5 cases occurred following falls from height, one following a high speed road traffic collision and one following suspected non-accidental injury. Only one patient...

Paediatric CSI is rare and was only identified in patients suffering high energy trauma in our cases series. Our limited data suggest that the prevalence of upper c-spine injury in this patient group is high (5/7, 71%) although the very limited number of cases precludes any meaningful statistical analysis. Our data also suggest that CT occult, significant soft tissue injuries which may result in spinal instability are also common, occurring in 1/7 (14.3%) of cases. It is therefore important that the reporting radiologist is aware...

1. Ruge JR, Sinson GP, McLone DG, Cerullo LJ. Pediatric spinal injury: the very young. J. Neurosurg. 1988;68:25–30. 2. Booth TN. Cervical spine evaluation in pediatric trauma. Am. J. Roentgenol. 2012;198:417–25. 3. Hutchings L, Willett K. Cervical Spine Clearance in Pediatric Trauma : A Review of Current Literature. J. Trauma. 2009;67:687–91. 4. Andronikou. Davies et al’s flawed criticism of the new NICE guideliens for cervical spine injury in children. Clin. Radiol. 2016; 5. Viccellio P, Simon H, Pressman BD, Shah MN, Mower WR, Hoffman JR....