A New Paradigm for the Management of Thoracolumbar Pediatric Spine Traumas
| Autor: | Romain Faguet, Ahmad Eid, Jacques Griffet, Baptiste Belvisi, E. Bourgeois, Aurélien Courvoisier |
|---|---|
| Přispěvatelé: | Service de chirurgie pédiatrique [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Santé, Plasticité, Motricité (TIMC-IMAG-SPM), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]) |
| Rok vydání: | 2017 |
| Předmět: |
Male
[SDV]Life Sciences [q-bio] Radiography MESH: Cervical Vertebrae MESH: Magnetic Resonance Imaging Breath Holding MESH: Spinal Injuries 0302 clinical medicine MESH: Breath Holding MESH: Child Fractures Compression Prospective Studies MESH: Fractures Compression Child Prospective cohort study MESH: Radiography 030222 orthopedics medicine.diagnostic_test General Medicine musculoskeletal system Magnetic Resonance Imaging 3. Good health medicine.anatomical_structure Child Preschool Cervical Vertebrae Emergency Medicine Spinal Fractures Female Cervical vertebrae musculoskeletal diseases medicine.medical_specialty Adolescent MESH: Spinal Fractures Inversion recovery Pediatric spine Sensitivity and Specificity 03 medical and health sciences medicine Humans MESH: Adolescent MESH: Humans business.industry [SCCO.NEUR]Cognitive science/Neuroscience MESH: Child Preschool 030208 emergency & critical care medicine Magnetic resonance imaging Spinal cord MESH: Prospective Studies MESH: Sensitivity and Specificity MESH: Male Sagittal plane Surgery Spinal Injuries Pediatrics Perinatology and Child Health business MESH: Female |
| Zdroj: | Pediatric Emergency Care Pediatric Emergency Care, Lippincott, Williams & Wilkins, 2017, 33 (8), pp.e10-e14. ⟨10.1097/PEC.0000000000000526⟩ |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000000526 |
| Popis: | OBJECTIVES The transient breath holding sign (TBHS) is a clinical sign often associated with magnetic resonance imaging (MRI) spine traumatic lesions. The aims of this study were to prospectively evaluate the TBHS in the detection of thoracolumbar lesions in a large cohort of children and to establish a comprehensive strategy on the use of MRI in spine traumas in children. STUDY DESIGN All conscious 5- to 16-year-old patients admitted for a spine trauma in our institution were prospectively included in the study. All patients were asked for the TBHS and underwent a full spine MRI. Sensitivity and specificity of the TBHS were derived from the confusion matrix. All MRI lesions were analyzed and classified. RESULTS One hundred ninety-eight patients were included. The sensitivity of the TBHS was 92%, the specificity was 83%, the positive predictive value was 83%, and the negative predictive value was 91%. The x-rays missed 67% of the vertebrae injured in the MRI. The MRI lesions consisted in an upper end plate injury, in the sagittal plane only, in 90% of the cases. The vertebral canal and the spinal cord were never injured. CONCLUSIONS This study confirms that the TBHS is a relevant clinical tool that should be added in the routine questionnaire after any trauma at admission. Magnetic resonance imaging should be restricted to patients with a TBHS positive at admission. A single T2 Short T1 Inversion Recovery (STIR) sagittal sequence seems sufficient to make the diagnosis and could replace the use of standard x-rays in pediatric spine traumas. |
| Databáze: | OpenAIRE |
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