August 7, 2026 · Journal of the American College of Surgeons · DOI: 10.1097/XCS.0000000000002117

Plain Radiograph Use in Pediatric Blunt Trauma Patients with Suspicion for Cervical Spine Injury: A Prospective Observational Analysis of the Western Pediatric Cervical Spine Study

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The authors aimed to evaluate the utilization and diagnostic performance of plain radiography (XR) in pediatric patients with suspected cervical spine injuries, specifically those meeting established criteria for XR-first imaging. Their study found that XR was underutilized, with only 39% of eligible patients receiving it, while demonstrating a high negative predictive value (NPV) of 99.9% for clinically significant injuries in appropriately selected cases. This suggests that implementing XR-first imaging strategies could significantly reduce the reliance on CT scans and associated radiation exposure in children.

Anastasia M Kahan, Hsuan-Yu Wan, R Scott Eldredge, Zachary J Kastenberg, Kezlyn E Larsen, Marshall W Wallace, Robert A Swendiman, Vijay M Ravindra, Katie W Russell, Western Pediatric Cervical Spine Study group

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