Study Introduces Rule To Halve Imaging Needs For Children's Cervical Spine Injuries

Cervical spine injuries in children, though uncommon, can lead to severe outcomes such as paralysis. Traditionally, these injuries are detected using X-rays and computed tomography (CT) scans. However, these methods expose children to radiation, posing potential long-term health risks. A study published on June 4 in The Lancet Child & Adolescent Health by the Pediatric Emergency Care Applied Research Network (PECARN) introduces a new approach that halves the need for imaging while ensuring injuries are not overlooked.

"Quickly and accurately identifying children with potentially severe injuries is crucial for emergency medical providers," said Dr. Julie Leonard, who led the PECARN study team and is a pediatric emergency medicine physician at Nationwide Children’s Hospital. "Our extensive, multicenter study demonstrates that using this rule, which relies on self-reported symptoms and physical examination, can prevent unnecessary radiation in children."

Children are more sensitive to radiation exposure than adults due to their developing tissues and cells. Imaging can also be stressful for both the child and their family, contribute to long wait times in emergency departments, and incur high costs. Additionally, research shows disparities in imaging use in emergency departments. Evidence-based rules can help standardize care.

The new model incorporates nine risk factors identifiable through physical examination. Among the 22,000 study participants, only 0.2% without any of these risk factors had a clinically significant cervical spine injury. This suggests that these children can be safely evaluated without imaging.

PECARN is part of the federal Emergency Medical Services for Children (EMSC) Program and is the first federally funded research network dedicated to advancing clinical knowledge in pediatric emergency care. The network includes researchers from 18 emergency departments and nine EMS agencies across 14 states.

PECARN is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of awards totaling $4,950,000 with 0% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of HRSA, HHS, or the U.S. Government.

Nationwide Children’s Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2023-24 "Best Children’s Hospitals," Nationwide Children’s Hospital is one of America’s largest not-for-profit pediatric health care systems. It houses the Department of Pediatrics of The Ohio State University College of Medicine, training future pediatricians, scientists, and specialists.

The Abigail Wexner Research Institute at Nationwide Children’s is one of the Top 10 National Institutes of Health-funded free-standing pediatric research facilities in the U.S.

For more information about PECARN and Nationwide Children’s Hospital, visit their respective websites at https://pecarn.org/ and www.nationwidechildrens.org/.