Purpouse – to define of diagnostic significance of x-ray examination of the cervical spine of children with complaints on headache.Retrospective comparative study was conducted. During the research, 159 medical histories of children from 5 to 17 years were analyzed: patients had complaints on headache and standard and functional x-ray examination of the cervical spine was prescribed and performed. 59 of those patients also had sonography examination of the vertebral arteries, and in 38 medical histories contained results of functional sonography test (examination of vertebral arteries in the middle and rotation positions of the head).All medical histories of children were divided in 3 groups based on the curvature of the cervical spine (p ≤ 0,01). Assessment of values of mobility indicators in the cervical spine, based on Kolmogorov-Smirnov criteria, revealed normal distributions in all three groups. Comparative analysis of values of the segmental mobility in the cervical spine in all 3 groups didn’t reveal statistically significant differences (p > 0,05). The significant correlation between values of sonography examination of the vertebral arteries, values of functional sonography tests and values of the segmental mobility in the cervical spine was not revealed.The x-ray examination of the cervical spine is not prioritized method of diagnostics in children with headache. Found cases of increasing segmental mobility in the cervical spine had not demonstrated significant change in blood flow in vertebral arteries in children.Prescription of X-ray of the cervical spine must be strictly justified recommendation if patients are children with complaints on headaches.
Compared to multiaxial computed tomography, the cone beam computed tomography has its benefits in terms of higher resolution imaging, including the construction of a 3D image, and in terms of several fold lower radiation exposure. The duration of scanning of less than 1 minute and the possibility to place a patient in the sitting position allow for the use of this method in various fields of stomatology, maxillofacial surgery, as well as in traumatology for the assessment of limb injuries. The paper presents our experience with the cone beam computed tomography as a single method for radiation diagnostics in children with cervical spine injuries. The first case is an example of the use of this method for primary diagnosis and subsequent follow-up of the restoration of the atlantoaxial position in a 9-year old child with rotatory subluxation of the atlant. To clarify the type of the injury, we combined and compared the axial planes of the 1st and 2nd cervical vertebrae. In the second case, we explored the possibility to assess the restoration of the bone structure and mutual position of the upper cervical vertebrae with the images obtained by cone beam computed tomography in a 9-year old girl with the Down's syndrome, who had been operated due to a cervical spine injury. The analysis of the cone beam computed tomography images from the first clinical case delineates the prospects of the method in the diagnostics of the atlant rotation subluxation in school-age children. Evaluation of the images obtained during the examination of the second clinical case has identified some disadvantages of the cone beam computed tomography, namely: 1) there is no way to control the fixed patient position, 2) limitations of the software to suppress artifacts arising from the metal construction, which leads to advanced image blurring and flatness, significantly hindering the identification of abnormalities.
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