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Evaluation of cervical spine injuries in children and adolescents

Alison Chantal Caviness, MD, MPH, PhD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


Cervical spine injury is rare in children. It is seen primarily in those who sustain significant, severe 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]. Any child who is suspected of having a cervical spine injury must be correctly immobilized in a neutral position until the injury is excluded [4]. The diagnosis or high suspicion of cervical spine injury requires prompt consultation with a neurosurgeon.

The evaluation of cervical spine injuries in children and adolescents is reviewed here. Techniques for immobilization of the pediatric cervical spine are discussed separately. (See "Pediatric cervical spine immobilization".)

The evaluation of cervical spine injuries in adults is discussed separately. (See "Evaluation and acute management of cervical spinal column injuries in adults", section on 'Radiographic evaluation of cervical spinal column injury'.)


Children younger than eight years of age are more susceptible to injury of the upper cervical spine (C1 to C3) than older children and adults because of certain features of their anatomic development (table 1) [2,3,5-10]:

They have relatively larger heads than bodies. The head circumference of a child reaches 50 percent of adult size by two years of age; in contrast, the chest circumference reaches 50 percent of adult size by eight years of age.


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Literature review current through: Jul 2017. | This topic last updated: May 25, 2016.
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