Discussion with Dr Wilkin-Marshall

Cervical spine injuries in children are uncommon and radiation risk from CT scans can be significant. We don’t have specific paediatric prediction rules for potential cervical spine injuries in children.

We review the new cervical spine injury prediction rule for children.

Bottom Line
A 9 Factor Clinical prediction tool was proposed, which had a

• Sensitivity of 94·3% (95% CI 90·7–97·9),
• Specificity of 60·4% (59·4–61·3), and
• NPV of 99·9% (99·8–100·0)

Will this lead to more imaging? This really depends on your current protocols. In Australia the answer is yes it will.

Will it lead to more plain cervical spine X-rays being done? Probably and if that is the case, when was the last time you looked at one?

The Paper:

Leonard J C et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health 2024; 8: 482–90. doi:10.1016/S2352-4642(24)00104-4