BMJ 2002;324:591-593 ( 9 March )

Clinical review

Lesson of the week

Immobilisation of the cervical spine in children

Recognition and early management of children at risk of injury to the cervical spinal cord is lacking

Sophie Skellett, fellow, Shane M Tibby, consultant, Andrew Durward, consultant, Ian A Murdoch, director. 

Department of Paediatric Intensive Care, Guy's Hospital, London SE1 9RT

Correspondence to: S Skellett sophie7@doctors.org.uk

The first 150 words of the full text of this article appear below.

Trauma to the cervical spine accounts for 1.5% of admissions in children with trauma in the United States, 35% of which have an associated injury of the cervical spinal cord.1 Such an injury may occur along with bony or ligamentous damage. Ligamentous damage encompasses injury to the spinal cord without radiological evidence of abnormalities.2 Immobilisation of the cervical spine is mandatory in patients at risk to prevent the development of injury to the cervical spinal cord and its progression.2-4

Most children requiring hospital admission for trauma are considered at risk of injury of the cervical spinal cord. The commonest causes are road crashes, falls from greater than 4.6 metres, head injuries, and injuries elsewhere to the spine. 5 6 These patients require immobilisation of the spine, commonly achieved with a rigid collar and a supplemental device. Immobilisation should be discontinued only after exclusion of bony and ligamentous damage, which needs an adequate clinical . . . [Full text of this article]
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