Defining pediatric cervical spine clearance with computed tomography: A prospective observational study by…

Cohort studyThe journal of trauma and acute care surgery· Aug 2026

Defining pediatric cervical spine clearance with computed tomography: A prospective observational study by the Western Pediatric Surgery Research Consortium and Western Trauma Association.

Katie W Russell, Anastasia M Kahan, Richard S Eldredge … and the Western Pediatric Cervical Spine Study Group, Salt Lake City, UT

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Emergency Trauma CareCohort studyDiagnosisQ1IF 3.4

Computed tomography alone detects 94.7% of significant pediatric cervical spine injuries after trauma.

Defining pediatric cervical spine clearance with computed tomography: A prospective observational study by the Western Pediatric Surgery Research Consortium and Western Trauma Association.

Katie W Russell … and the Western Pediatric Cervical Spine Study Group, Salt Lake City, UT

The journal of trauma and acute care surgery · Aug 2026

Background

The optimal imaging strategy for pediatric cervical spine clearance remains controversial.

Purpose

We hypothesized that computed tomography is sufficiently sensitive to allow for definitive clearance of the pediatric cervical spine after blunt trauma.

Methods

We conducted a prospective, multicenter, observational study from March 1, 2022, to July 31, 2025, at 72 diverse adult, mixed, and pediatric trauma centers across the United States.

n = 4,673

Results

Computed tomography alone correctly ruled out significant cervical spine injury in almost all cases

Sensitivity 94.70 (95% CI 89.40 to 97.50)

null 0

89.40

97.50

CI excludes the null - significant

More results

We prospectively enrolled 19,651 pediatric patients, of whom 12,693 (65%) underwent cervical spine computed tomography and comprise the analytic cohort.

The median age was 12 (interquartile range, 6-15), 37% (n=4,673) were female, and 19% (n=2,389) were obtunded, defined as GCS ≤13.

More results

Error analysis identified eight patients with false-negative computed tomography interpretations, of which six injuries were identifiable on retrospective review.

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Conclusion · 1 of 3

In pediatric blunt trauma patients evaluated for cervical spine injury, computed tomography is highly sensitive for detecting clinically significant injuries.

Conclusion · 2 of 3

These findings support pediatric cervical spine clearance based on a normal cervical spine computed tomography. (J Trauma Acute Care Surg. 2026;00: 000-000. © 2026 The Author(s). Published by Wolters Kluwer Health, LLC.

Conclusion · 3 of 3

on behalf of the American Association for the Surgery of Trauma.). LEVEL OF EVIDENCE: Prospective Cohort Study; Level II.

Defining pediatric cervical spine clearance with computed tomography: A prospective observational study by the Western Pediatric Surgery Research Consortium and Western Trauma Association.

Defining pediatric cervical spine clearance with computed tomography: A prospective observational study by the Western Pediatric Surgery Research Consortium and Western Trauma Association.

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