Prevalence of cervical spine injury in infants with head trauma.
OBJECTIVE
The incidence, type, and severity of pediatric cervical spine injuries (CSIs) are related to age and mechanism of injury. In this study, the authors assessed the prevalence of CSIs in infants with head trauma treated in their institution.


METHODS
The authors reviewed the medical records of children younger than 1 year of age who presented to The Children's Hospital with head injuries between January 1993 and December 2007. They excluded infants with head injuries resulting from motor vehicle accidents and known falls from heights greater than 10 ft. For each patient, collected data included age, cause of injury, diagnosis, discharge disposition, and outcome. Relevant imaging data were reviewed, and when appropriate, autopsy reports were also reviewed.


RESULTS
Nine hundred five infants with head trauma and without a major mechanism/cause were identified. Their mean age was 4.3 months. Of the 905 patients, only 2 cases of CSI were detected, giving a prevalence of 0.2%. The mechanism of injury in these 2 patients was nonaccidental trauma (NAT).


CONCLUSIONS
The study revealed a very low prevalence of CSIs in infants with head trauma (0.2%). Routine cervical spine imaging in these infants, therefore, appears to have low diagnostic yield. The mechanism of head injury was NAT in the 2 patients who sustained an associated CSI. This supports the need for more stringent cervical spine imaging criteria for the infant with suspected NAT.
Katz
Joel S
JS
Department of Pediatric Neurosurgery, The Children's Hospital, University of Colorado, Aurora, Colorado 80045, USA.
Oluigbo
Chima O
CO
Wilkinson
C Corbett
CC
McNatt
Sean
S
Handler
Michael H
MH
D002574:Cervical Vertebrae / Q000293:injuries*; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data; D003120:Colorado; D003430:Cross-Sectional Studies; D005260:Female; D016489:Head Injuries, Closed / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed