![]() No CSI were missed during the study period. ![]() MRI rates were similar in patients in the 2 groups (4.0% pre- and 4.9% post-guideline, respectively P = 0.60). These changes are normal and they occur in everyone. The mean radiation dose exposure was significantly less for patients undergoing C-spine CT in the post-guideline period than before its implementation (mean values, 114 and 265 mGy-cm -1, respectively P <0.001). Cause Cervical spondylosis arises from degenerative changes that occur in the spine as we age. Conversely, rates of C1-C4 CT were significantly higher in the post-guideline period (11.5% compared to 0.4% in the pre-guideline period, P <0.001). However, rates of full C-spine CT were 22.7% in the pre-guideline period vs 11.9% after guideline implementation (P <0.001). Similarly, rates of any C-spine CT were not significantly different (23.1% and 23.4%, respectively P = 0.92). Rates of C-spine radiographs were similar during the 2 study periods (26% pre-guideline and 27% post-guideline). The median age of children seen in the pre- and post-guideline periods was 3.5 and 3.6 years, respectively P = 0.69. This includes the seven bones of your neck that surround and protect the top section of your. A rank sum test was used to compare radiation dose exposure among those in the pre- and post-guideline periods.ĭata on 726 children <8 years old screened for CSI were analyzed, with 273 patients evaluated in the pre-guideline phase and 453 seen after its implementation. A neck X-ray, also known as a cervical spine X-ray, is an X-ray image taken of your cervical vertebrae. Rates of any C-spine CT, full, and C1-C4 C-spine CT among patients treated in the pre- and post-guideline periods were compared with chi-square tests. Data on radiation dose was extracted from radiology results. C-spine CTs were classified as full or C1-C4. Data on C-spine radiographs, C-spine CTs, and MRI of the C-spine were collected. The medical records of these study participants were reviewed and demographic and clinical information abstracted. To assess the impact of the guideline, data on patients <8 years old evaluated in the trauma center for CSI between July 2017 and December 2020 were identified by review of a prospectively maintained trauma registry. Standardized order sets were included in the electronic medical record to encourage adherence to the guideline, which was implemented in September 2018. If a C-spine CT was indicated, the guideline recommended limiting the scan to the C1-C4 region rather than including the entire C-spine. The guideline encouraged clinical clearance of the C-spine to be based on physical examination in children <8 years old, when appropriate. Specifically, in 2018, a guideline was developed at a pediatric level 2 trauma center designed to limit radiation exposure from CT in young children. Investigators from the UNLV School of Medicine, Las Vegas, NV, conducted a retrospective study to assess the impact of a cervical spine (C-spine) clearance guideline on rates of full and limited C-spine CT scans performed in children <8 years old being evaluated for C-spine injury (CSI), and radiation dose exposure.
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