Cervical fractures

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Author: Mikael Häggström [notes 1]


Choice of modality in trauma

Recommendations differ somewhat between children and adults:

  • In children, CT of the neck in trauma is indicated in more severe cases such as neurologic deficits, whereas X-ray of the cervical spine is preferable in milder cases, by both US[1] and UK[2] guidelines. Swedish guidelines recommend CT rather than X-ray in all children over the age of 5.[3] It is thus reasonable to indicate CT by a combination of higher severity and older age.
  • In adults, UK guidelines are largely similar as in children.[2] US guidelines, on the other hand, recommend CT of the neck in trauma in all cases where medical imaging is indicated, and that X-ray of the cervical spine is only acceptable where CT is not readily available.[4]


Follow-up of known cervical fractures:

  • Generally CT
  • X-ray is acceptable for follow-up where evaluation of movement of a vertebral body or vertebral arch is enough. It is preferable with bone attached orthoses that will create artifacts on CT imaging.


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.


  1. Julie C Leonard (2018-02-12). Evaluation and acute management of cervical spine injuries in children and adolescents. UpToDate.
  2. 2.0 2.1 . Head injury: assessment and early management. National Institute for Health and Care Excellence (NICE) (2014). Updated in June 2017
  3. . Traumamanual. Region Skåne. Last updated: 2018-03-29
  4. Amy Kaji, Robert S Hockberger (2018-05-24). Evaluation and acute management of cervical spinal column injuries in adults.