{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T19:34:43Z","timestamp":1764617683840,"version":"3.46.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Surgical intervention for thoracolumbar spinal injury (TLSI) is rare in pediatric trauma. Current guidelines recommend CT scanning of the entire spine if one spinal injury is found, and localized CT if spinal injury is suspected, likely resulting in significant radiation exposure for these injuries. This study identifies the frequency of various imaging techniques utilized across trauma centers of varied designations for confirmed pediatric TLSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The American College of Surgeons Trauma Quality Improvement Program Participant Use File (TQIP PUF) was queried from 2017 to 2022. Patients aged younger than or equal to 14 years with thoracic or lumbar injuries were included. ICD-10 codes for injuries, imaging, procedures, and bracing were analyzed by patient age and trauma center level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirteen thousand three hundred ten children were identified with blunt TLSI. The most common injury was thoracic spine fracture (58.23%) followed by lumbar spine fracture (45.11%). Spinal cord injuries were less common (5.8% lumbar, 7.18% thoracic), as were joint injuries (5.8% lumbar, 0.86% thoracic). The need for surgical intervention was rare (6.49%) and varied significantly with age and trauma center type. Older children were more likely to be evaluated with CT and younger children were more likely to be evaluated with MRI. Adult centers were much more likely to image with CT, and pediatric centers were much more likely to use plain film or MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although TLSI is common in blunt pediatric trauma, intervention is rarely needed. CT imaging is liberally used, particularly in adult trauma centers. Improved guidelines for cross-sectional imaging in neurologically normal patients are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000003460","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T08:00:09Z","timestamp":1753776009000},"page":"944-949","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Blunt Thoracolumbar Spinal Injury"],"prefix":"10.1097","volume":"41","author":[{"given":"Tarun","family":"Prabhala","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9532-249X","authenticated-orcid":false,"given":"Ava","family":"Herzog","sequence":"additional","affiliation":[{"name":"Albany Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashar","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albany Medical Center, Albany, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Adamo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albany Medical Center, Albany, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"R1-20251201","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.RVW.24.00045","article-title":"Evaluation and management of thoracolumbar spine trauma in pediatric patients: a critical analysis review","volume":"12","author":"Bonsignore-Opp","year":"2024","journal-title":"JBJS Rev"},{"key":"R3-20251201","first-page":"537","article-title":"Multiple level injuries in pediatric spinal trauma","volume":"67","author":"Mahan","year":"2009","journal-title":"J Trauma"},{"key":"R4-20251201","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2214\/ajr.176.2.1760289","article-title":"Estimated risks of radiation-induced fatal cancer from pediatric CT","volume":"176","author":"Brenner","year":"2001","journal-title":"AJR Am J Roentgenol"},{"key":"R5-20251201","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1177\/0194599814542588","article-title":"Risk of malignancy associated with head and neck CT in children: a systematic review","volume":"151","author":"Chen","year":"2014","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R6-20251201","doi-asserted-by":"crossref","first-page":"707","DOI":"10.5435\/00124635-201312000-00001","article-title":"Pediatric thoracolumbar spine trauma","volume":"21","author":"Daniels","year":"2013","journal-title":"J Am Acad Orthop Surg"},{"key":"R7-20251201","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/01.ta.0000200852.56822.77","article-title":"The clinical presentation of pediatric thoracolumbar fractures","volume":"60","author":"Santiago","year":"2006","journal-title":"J Trauma"},{"key":"R8-20251201","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.3390\/children8121127","article-title":"Spine fractures in children and adolescents-frequency, causes, diagnostics, therapy and outcome\u2014A STROBE-Compliant Retrospective Study at a Level 1 Trauma Centre in Central Europe","volume":"8","author":"Payr","year":"2021","journal-title":"Children"},{"key":"R9-20251201","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s00247-003-1046-y","article-title":"Distribution of spinal fractures in children: does age, mechanism of injury, or gender play a significant role?","volume":"33","author":"Reddy","year":"2003","journal-title":"Pediatr Radiol"},{"issue":"5S","key":"R10-20251201","first-page":"S264","article-title":"ACR Appropriateness Criteria((R)) Suspected Spine Trauma","volume":"16","author":"Musculoskeletal","year":"2019","journal-title":"J Am Coll Radiol"},{"key":"R11-20251201","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/TA.0000000000000643","article-title":"Implementation of pediatric cervical spine clearance guidelines at a combined trauma center: twelve-month impact","volume":"78","author":"Rosati","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"R12-20251201","first-page":"CD011686","article-title":"Triage tools for detecting cervical spine injury in pediatric trauma patients","volume":"12","author":"Slaar","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"R13-20251201","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/TA.0000000000000884","article-title":"Thoracolumbar spine clearance: clinical examination for patients with distracting injuries","volume":"80","author":"Cason","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"R14-20251201","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0736-4679(02)00659-5","article-title":"Prospective evaluation of criteria for obtaining thoracolumbar radiographs in trauma patients","volume":"24","author":"Holmes","year":"2003","journal-title":"J Emerg Med"},{"key":"R15-20251201","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/TA.0000000000003983","article-title":"Utility of computed tomography reconstructed thoracolumbar spinal imaging in blunt trauma","volume":"95","author":"Swarup","year":"2023","journal-title":"J Trauma Acute Care Surg"},{"key":"R17-20251201","doi-asserted-by":"crossref","first-page":"e2024066855","DOI":"10.1542\/peds.2024-066855","article-title":"Optimizing advanced imaging of the pediatric patient in the emergency department: technical report","volume":"154","author":"Marin","year":"2024","journal-title":"Pediatrics"},{"key":"R18-20251201","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.neuchi.2021.06.014","article-title":"Thoracolumbar spinal fracture in children: Conservative or surgical treatment?","volume":"68","author":"Gavira","year":"2022","journal-title":"Neurochirurgie"},{"key":"R19-20251201","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/TA.0000000000003928","article-title":"Hospital variability in adoption of alcohol and drug screening in adult trauma patients","volume":"94","author":"Silver","year":"2023","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T19:00:54Z","timestamp":1764615654000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003460"}},"subtitle":["Defining the Burden of Injury and Imaging Practices"],"short-title":[],"issued":{"date-parts":[[2025,7,29]]},"references-count":17,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003460","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"type":"print","value":"0749-5161"},{"type":"electronic","value":"1535-1815"}],"subject":[],"published":{"date-parts":[[2025,7,29]]},"assertion":[{"value":"2025-02-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}