Title: Cervical spine clearance in pediatrics
题目：小儿颈椎外伤筛查
Author 作者: Jennifer Guyther
翻译：葛赟 校对：肖锋

The NEXUS criteria is widely applied to adults who present with neck pain due to trauma.  While this study did include about 2000 pediatric patients, there were not enough young children to draw definitive conclusions.  A 2003 study piloted an algorithm for cervical spine clearance in children < 8 years.

NEXUS标准广泛应用于外伤引起颈部疼痛的成人。虽然本研究收集了2000例儿童，但是还是因数量不足而不能显示明确的结果。 2003年的研究提出了一个关于＜8岁儿童的颈椎筛选路径。

Patients were spine immobilized if: unconscious, abnormal neurological exam, history of transient neurological symptoms, significant mechanism of injury, neck pain, focal neck tenderness or inability to assess based on distracting injury (extremity or facial fractures, open wound, thoracic injuries, or abdominal injuries), physical exam findings of neck trauma, unreliable exam due to substance abuse, significant trauma to the head or face, or inconsolable children.

如果出现下列情况需要进行颈椎制动：意识不清，神经系统体征阳性，有短暂性神经症状的病史，有明显的损伤机制，颈部疼痛，局灶性颈部压痛或因伴有可以转移注意力的其它损伤而无法评估（四肢或面部骨折，开放伤，胸部损伤，或腹部损伤），体检发现颈部外伤，因毒物质中毒影响体检，头面部的明显外伤，或不安静的儿童。

When the 2 pathways were implemented, there was a decrease in time to cervical spine clearance.  There were no missed injuries in the study period prior to implementation of the pathway or once it was implemented.  There was no significant difference in the amount of xrays, CT scans or MRIs.

当两个路径都使用时，颈椎外伤筛选时间减少。在本研究期间，路径前后没有漏掉的外伤。同时在X线，CT扫描和MRI检查数量之间无明显差异。
References 参考文献：
Lee S, Sena M, Greenholtz, S, Fledderman M.  A Multidisciplinary Approach to the Development of a Cervical Spine Clearance Protocol: Process, Rationale, and Initial Results.  Journal of Pediatric Surgery 2003; 38 (3): 358-362.