Diagnostic Yield of Axial Computed Tomography Scans for Pediatric Axial Skeletal Injuries. Issue 13 (1st July 2021)

• Record Type: Journal Article
• Authors: Maqsoodi, Noorullah; Louis, Clauden; Botros, Mina; Baldwin, Avionna; Jefferson, Jamal; Moses, Jalea T.; Wakeman, Derek; Mesfin, Addisu
• Is Part Of: Spine. Volume 46:Issue 13(2021)
• Publication Date: 2021-07-01
• Subjects: cervical -- cervical fractures -- computed tomography imaging -- lumbar -- pediatric spine trauma -- sacral fractures -- sacrum -- thoracic -- thoracolumbar fractures -- trauma imaging; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000003932
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective cohort study. Objective: To evaluate the diagnostic yield of computed tomography (CT) imaging of the axial skeleton in pediatric patients evaluated a level I trauma center. Summary of Background Data: CT imaging has become ubiquitous in the assessment of axial skeletal injuries in trauma patients. Methods: This is a retrospective study from one Level I trauma center of patients undergoing CT imaging during pediatric trauma assessment. Medical records of pediatric trauma patients 18-year old and younger who underwent axial skeletal CT imaging from 2013 to 2015 were evaluated. The following were assessed: mechanism of injury, age, sex, race/ethnicity, presence of fracture, management of fracture. Results: A total of 831 patients were assessed, there were 355 (42.7%) females and 476 males (57.3%) with an average age of 15.4 (2 mo–18 yrs). 588 (70.8%) were White, 164 (19.7%) were African-American, 12 (1.4%) were Asians, 67 (8.1%) other, and 46 (5.5%) identified as Hispanic. There were 45 patients (5.4%) who sustained 52 fractures. Common mechanisms were motor vehicle accidents (MVA) 28%, sports injuries (18%), and fall from height (15%). 35.9% of fractures were identified on plain radiographs. Nine injuries were treated surgically (one cervical, two thoracic, two lumbar, and four pelvic); three of these were identified on radiographs. From the 14 patients with cervical spine fractures none were detected on radiographs. Conclusion: In this large series of 831 pediatric patients undergoing axial CT imaging, the rate of axial fractures was 5.4%. The majority of these fractures were managed non-surgically. Only 35.9% of fractures were identified on radiographs. Level of Evidence: 3 Abstract : Of 831 pediatric patients undergoing axial computed tomography (CT) imaging, the rate of axial fractures was 5.4% (45 patients). Of patients with fractures who underwent plain radiographs, 35.9% of fractures were identified on plain radiograph and the rest were identified on CT. Nine of 45 patients underwent surgical treatment.