Pediatric cervical spine immobilization
- Alison Chantal Caviness, MD, MPH, PhD
Alison Chantal Caviness, MD, MPH, PhD
- Associate Professor of Pediatric Emergency Medicine
- Baylor College of Medicine
- Section Editor
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Cervical spine injury is rare in children. It is primarily seen in children who sustain blunt trauma, occurring in 1 to 2 percent of such cases [1,2]. The injury may involve bones, ligaments, blood vessels, or the spinal cord, and must be rapidly recognized and treated to avoid permanent disability or death [3,4].
The cervical spine must be immobilized in any child who is suspected of having a cervical spine injury until the injury is excluded . Immobilization should be established in the prehospital setting, or failing that, upon presentation to the healthcare facility. It should be continued until injury is ruled out clinically or radiographically . An estimated 3 to 25 percent of patients with spinal cord injury develop neurologic deficits caused by manipulation during resuscitation or transport [1,3,6]. Extension of cervical cord injury can be avoided with proper immobilization and careful airway management .
Techniques for immobilization of the cervical spine are reviewed here. The evaluation of cervical spine injuries is discussed separately. (See "Evaluation and acute management of cervical spine injuries in children and adolescents".)
INDICATIONS FOR IMMOBILIZATION
The cervical spine must be immobilized if certain historical or physical examination features are present. Mechanisms of injury that are associated with a high risk of cervical spine injury include:
●Severe force (eg, motor vehicle crash or fall)
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