This 1998 narrative review by Copley and Dormans covers the full spectrum of cervical spine disorders in children — from developmental anatomy and normal radiographic variants to congenital anomalies, trauma, and systemic conditions — asking how pediatric cervical evaluation and management differ from the adult approach.
When evaluating a child under 8 with neck pain or trauma, remember that apparent C2-3 step-off may be normal pseudosubluxation (use Swischuk's line to confirm), upper cervical injuries dominate and carry higher fatality risk, and systemic conditions like Down syndrome or Morquio syndrome mandate baseline flexion-extension films with attention to ADI and SAC thresholds — not just a single neutral lateral.
This 1998 narrative review by Copley and Dormans covers the full spectrum of cervical spine disorders in children — from developmental anatomy and normal radiographic variants to congenital anomalies, trauma, and systemic conditions — asking how pediatric cervical evaluation and management differ from the adult approach.
When evaluating a child under 8 with neck pain or trauma, remember that apparent C2-3 step-off may be normal pseudosubluxation (use Swischuk's line to confirm), upper cervical injuries dominate and carry higher fatality risk, and systemic conditions like Down syndrome or Morquio syndrome mandate baseline flexion-extension films with attention to ADI and SAC thresholds — not just a single neutral lateral.