Advanced Cervical Spine Imaging in Abusive Head Trauma: An Update on Recent Literature and Future Directions
Young children with traumatic brain injury (TBI), and in particular abusive head trauma (AHT), have been identified as being at risk for concurrent spinal injuries, but a standardized approach to cervical spine imaging has not been identified in this population. In 2016, we examined cervical spine imaging practices among children younger than 2 years old with TBI across a sample of US hospitals.1 We found that hospitals varied in their use of advanced cervical spine imaging, defined as computed tomography (CT) or magnetic resonance imaging (MRI). Specifically, the probability of advanced cervical imaging across hospitals ranged from 4.3% to 84.3% in cases of abusive head trauma and from 3.1% to 39.0% in cases of TBI from falls and could not be attributed to differences in patient populations. Though the identified variation highlighted opportunities for quality improvement, our study was unable to identify the optimal imaging practice.