{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:53:24Z","timestamp":1787169204896,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>After evaluation and treatment of minor traumatic cervical spine injury (CSI), many children are discharged home in a rigid cervical orthosis (RCO). This study investigated their adherence to RCO treatment recommendations. The feasibility of telehealth cervical spine clearance was also explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective observational study of children 3 to 18 years old with mild CSI evaluated at a level I pediatric trauma center from December 1, 2019, through July 31, 2021. Before emergency department discharge, patients received RCO use instructions and recommendation for follow-up with in-person neurosurgery clinic visit, neurosurgery telehealth visit, or in-person primary care provider visit. The family was responsible for arranging follow-up. Primary outcomes included compliance with follow-up and collar use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-eight children (mean age, 11.3 \u00b1 4.1 years) were included. Overall, follow-up contact was available for 51 patients (52%). At 1-week follow-up with 36 children, 64% were collar compliant, 13 had no pain (38% remained in RCO), 14 had mild pain without limitations, 8 had pain with some limitations, and 1 had significant pain. At 2-week follow-up with 31 children, 9 (29%) were collar compliant, 23 had no pain, 7 had mild pain without limitations, and 1 with significant persistent pain was found to have an odontoid fracture requiring C1\u20132 fusion. Patients\/families often discontinued the use of the collar without follow-up (47%). Approximately half utilized a recommended clinical follow-up option for clearance, most often in neurosurgery clinic or using a neurosurgery telehealth visit. The mean time to follow-up was 11.34 \u00b1 4.9 days (range, 3\u201325 days), and mean collar compliance lasted 9.8 \u00b1 5.7 days (range, 1\u201325 days). No child experienced any short-term complications related to RCO use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this pilot study, a substantial portion of children with mild CSIs discharged from the emergency department with an RCO did not adhere to compliance or follow-up recommendations. Persistent pain requires further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000002755","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T10:26:26Z","timestamp":1653560786000},"page":"274-278","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["The Fate of the Cervical Collar"],"prefix":"10.1097","volume":"39","author":[{"given":"Hilary A.","family":"Hewes","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ryan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie W.","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Soisson","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas L.","family":"Brockmeyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, School of Medicine, University of Utah, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/PEC.0000000000000819","article-title":"Cervical spine injuries in children associated with sports and recreational activities","volume":"34","year":"2018","journal-title":"Pediatr Emerg Care"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1197\/j.aem.2005.03.530","article-title":"A system for grouping presenting complaints: the pediatric emergency reason for visit clusters","volume":"12","year":"2005","journal-title":"Acad Emerg Med"},{"key":"bib4-20250504","first-page":"536080","article-title":"Common presenting problems for young people attending the emergency department","volume":"2014","year":"2014","journal-title":"Adv Emerg Med"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.18.00217","article-title":"Pediatric cervical spine clearance: a consensus statement and algorithm from the Pediatric Cervical Spine Clearance Working Group","volume":"101","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"e20183221","DOI":"10.1542\/peds.2018-3221","article-title":"Cervical spine injury risk factors in children with blunt trauma","volume":"144","year":"2019","journal-title":"Pediatrics"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1097\/TA.0000000000002396","article-title":"Single-lateral cervical radiograph in pediatric trauma is equivalent to multiple views","volume":"87","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/PEC.0b013e3182531911","article-title":"Utility of plain radiographs in detecting traumatic injuries of the cervical spine in children","volume":"28","year":"2012","journal-title":"Pediatr Emerg Care"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/PEC.0000000000001026","article-title":"Examination of pediatric radiation dose delivered after cervical spine trauma","volume":"34","year":"2018","journal-title":"Pediatr Emerg Care"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.1542\/peds.108.2.e20","article-title":"A prospective multicenter study of cervical spine injury in children","volume":"108","year":"2001","journal-title":"Pediatrics"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1056\/NEJM200007133430203","article-title":"Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. 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