Computed tomographic evaluation of C1–C2 in Pediatric cervical spine trauma

The supine open-mouth odontoid view required in most cervical spine trauma series often is difficult to obtain, especially in the pediatric or uncooperative patient. This retrospective study compared thin-section computed tomography with multiplanar reconstructions and the standard plain film cervical spine examination for evaluation of C1–C2 in a group of 31 pediatric patients age 6 years and under with combined craniocervical trauma. The plain film examination demonstrated adequate visualization of C1–C2 in only 58% of patients. The average number of anteroposterior odontoid films was 3.5 per examination (range, 1–6 films). Only 9% of anteroposterior open-mouth odontoid views were felt to be of adequate diagnostic quality vs. 60% of the Fuch’s odontoid view. The computed tomographic examination was diagnostic in 91% of examinations and could be acquired more rapidly.