Pediatric cervical spine in emergency: radiographic features of normal anatomy, variants and pitfalls

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• 作者：Omar Adib ; Emeline Berthier ; Didier Loisel ; Christophe Aubé
• 关键词：Pediatric spine ; Radiograph ; Anatomy ; Variants
• 刊名：Skeletal Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：45
• 期：12
• 页码：1607-1617
• 全文大小：5,854 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Orthopedics
  Pathology
  Nuclear Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-2161
• 卷排序：45

文摘

Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult. Such features as hypermobility between C2 and C3, pseudospread of the atlas on the axis, pseudosubluxation, the absence of lordosis, anterior wedging of vertebral bodies, pseudowidening of prevertebral soft tissue and incomplete ossification of synchondrosis can be mistaken for traumatic injuries. The interpretation of a plain radiograph of the pediatric cervical spine following trauma must take into account the age of the child, the location of the injury and the mechanism of trauma. Comprehensive knowledge of the specific anatomy and biomechanics of the childhood spine is essential for the diagnosis of suspected cervical spine injury. With it, the physician can, on one hand, differentiate normal physes or synchondroses from pathological fractures or ligamentous disruptions and, on the other, identify any possible congenital anomalies that may also be mistaken for injury. Thus, in the present work, we discuss normal radiological features of the pediatric cervical spine, variants that may be encountered and pitfalls that must be avoided when interpreting plain radiographs taken in an emergency setting following trauma.