Plain X-rays and Physical Exam Reliably Screen Pediatric Thoracolumbar Injuries

Thoracolumbar spinal injuries in children are less common than in adults but carry the risk of substantial morbidity, making accurate and timely diagnosis essential [1]. While imaging is a cornerstone of pediatric trauma evaluation, the optimal initial strategy remains debated [2, 3]. Widespread use of computed tomography (CT) for screening, though sensitive, exposes children to significant radiation, a pressing concern in this vulnerable population [4]. Conversely, the utility of plain radiography is inconsistent across institutions, partly due to a lack of robust evidence supporting its use as a primary screening tool. This gap in evidence creates a clinical dilemma, balancing the need for diagnostic certainty against the risks of radiation exposure.