University of Rochester Department of Imaging Sciences, Rochester, NY, USA.
University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Clin Imaging. 2022 Jul;87:61-76. doi: 10.1016/j.clinimag.2022.04.012. Epub 2022 Apr 28.
Trauma to the pediatric spine can manifest as osseous, disco-ligamentous, and/or neurological injuries. Associated mortality is significantly higher than in adults. Injury patterns in children are distinct from those encountered in adults. Although spine radiographs are the first line of diagnosis, they may be challenging to interpret in children due to the difficulty of applying recognized radiographic landmarks to the partially ossified spine. Ligamentous laxity and developmental phenomena also lead to imaging pitfalls. Much of the recent literature on this subject focuses on region-specific injuries or individual entities, and may not be tailored specifically to the radiologist, thereby not stressing key aspects pertinent to the effective performance and successful interpretation of imaging exams. We aim to address this void. We provide a comprehensive review of pediatric spine trauma, outlining the clinical decision tools, imaging protocols including the current American College of Radiology (ACR) appropriateness guidelines, interpretive pitfalls and tips to navigate these pitfalls, and management implications of the spectrum of these injuries. Throughout the text, extensive tables, illustrations and imaging examples reinforce key concepts.
儿童脊柱创伤可表现为骨、椎间盘-韧带和/或神经损伤。其相关死亡率明显高于成人。儿童的损伤模式与成人不同。尽管脊柱 X 线片是诊断的首选方法，但由于难以将公认的 X 线片标志应用于部分骨化的脊柱，因此在儿童中可能难以解释。韧带松弛和发育现象也会导致成像陷阱。关于这个主题的大部分最新文献都集中在特定区域的损伤或单个实体上，并且可能没有专门针对放射科医生进行定制，因此没有强调与有效执行和成功解释成像检查相关的关键方面。我们旨在解决这一空白。我们全面回顾了儿童脊柱创伤，概述了临床决策工具、成像方案，包括当前的美国放射学会 (ACR) 适宜性指南、解释性陷阱以及解决这些陷阱的技巧，以及这些损伤谱的管理意义。在整个文本中，大量的表格、插图和成像示例强化了关键概念。
