Department of Surgery, Albany Medical Center, Albany, NY.
Department of Surgery, Division of Neurosurgery, Albany Medical Center, Albany, NY.
J Pediatr Surg. 2021 Feb;56(2):293-296. doi: 10.1016/j.jpedsurg.2020.05.009. Epub 2020 May 11.
Pediatric cervical spine injury (PCSI) in children is rare. Incidence of PCSI requiring intervention is not known, and imaging practices for screening in United States trauma centers are not well described.
The 2016 NTDB was queried for patients younger than 15 years with PCSI. Incidence of PCSI, operative interventions, and imaging rates were analyzed by age and ACS accreditation status.
Of 84,554 children, 873 (1.03%) had PCSI. Patients <4 years were less likely to have PCSI (0.68% vs. 1.1%, RR 0.59, p < 0.001). 165 children (0.20%) required an intervention for PCSI. 12.8% of all children were screened for PCSI with imaging, 9.3% with CT, and 3.2% with plain X-rays. In spite of similar injury and intervention rates, stand-alone pediatric trauma centers were less likely than others to image patients without PCSI (11% vs. 13% p < 0.001), less likely to utilize CT scan (5.8% vs. 10.6% p < 0.001) and more likely to utilize plain films (5.2% vs. 2.4% p < 0.001).
Despite exceedingly low rates of PSCI requiring intervention (0.2%), imaging rates for screening are significant. Stand-alone pediatric trauma centers outperform others in limiting unnecessary imaging.
IV.
儿童颈椎损伤（PCSI）较为少见。需要干预的 PCSI 的发生率尚不清楚，美国创伤中心筛查的影像学实践也没有很好的描述。
对 2016 年 NTDB 中年龄小于 15 岁的患有 PCSI 的患者进行了查询。按年龄和 ACS 认证状态分析了 PCSI 的发生率、手术干预和影像学检查率。
在 84554 名儿童中，有 873 名（1.03%）患有 PCSI。年龄小于 4 岁的患儿发生 PCSI 的可能性较小（0.68%比 1.1%，RR 0.59，p<0.001）。165 名（0.20%）患儿因 PCSI 需要干预。对所有患儿进行影像学检查的比例为 12.8%，CT 检查为 9.3%，平片为 3.2%。尽管损伤和干预率相似，但与其他类型的创伤中心相比，单纯的儿科创伤中心对没有 PCSI 的患者进行影像学检查的可能性更小（11%比 13%，p<0.001），更不可能使用 CT 扫描（5.8%比 10.6%，p<0.001），更可能使用平片（5.2%比 2.4%，p<0.001）。
尽管需要干预的 PCSI 发生率极低（0.2%），但用于筛查的影像学检查率却很高。单独的儿科创伤中心在限制不必要的影像学检查方面优于其他中心。
IV。
