Back Pain
This is required prior to spine imaging for pediatric patients.
What is an X-ray?
This is the guideline used to review pediatric spine imaging for spondylolosis.
What is PEDSP 2.4?
This guideline is to be used when there is a concern for infection of the spine for the pediatric patient.
What is PEDSP 2.5?
Imaging evaluation of traumatic spine injury in children is generally directed based on this.
What is clinical exam?
The most widely used measurement to quantify the magnitude of spinal deformities, especially in the case of scoliosis, on plain radiographs.
What is the Cobb angle?
This is not required for ages 5 and under if pain is more than just mild and transient.
What is conservative treatment?
Surgical treatment would be recommended in these types of patients.
What is patients with disabling symptoms that have not responded to non-surgical care?
These are the criteria that must be met prior to imaging when there is a concern for spinal infection in the pediatric patient.
What is physical exam with thorough neuro exam and x-ray of the relevant spine level?
Children under 3 years of age should be approved for this area of the spine following a recent (within 60 days) x-ray.
What is cervical spine?
Congenital scoliosis is recognized in during this stage of childhood.
What is infancy or early childhood?
This is the guideline and section to follow when spine imaging is requested for a pediatric patient and they have pain which is extremely severe or worse at night.
What is a PEDSP 2.3 for pediatric red flag?
Spondylolysis is best recognized by this.
What is plain X-Rays?
This is the appropriate imaging when there is a concern for spinal infection in the pediatric patient.
What is MRI w/wo of the symptomatic spine level or bone scan or nuclear bone marrow imaging or radiopharmaceutical inflammatory imaging or SPECT or SPECT/CT?
The age of children when imaging can be approved for advanced imaging of the thoracolumbar spine following a recent x-ray when x-rays are inconclusive, or there is an abnormal neurological examination.
What is age 17 and younger unless otherwise specified by a specific health plan?
What is standing posterior-anterior (PA) and lateral views with degrees of spine curvature?
In the absence of any red flags this should be attempted.
What is a 4 week trial of provider-supervised conservative treatment?
This should be the initial treatment when there is concern for spondylolysis in the pediatric patient.
What is activity modification, NSAID treatment, physical therapy, and/or immobilization with various braces?
This imaging is appropriate for evaluation of response to treatment in established spinal osteomyelitis for the pediatric patient.
What is bone scan or nuclear bone marrow imaging or radiopharmaceutical localization imaging?
Children older than 2 years of age SHOULD NOT be approved for advanced imaging of the cervical spine if all of these criteria are met.
What is absence of posterior midline cervical pain, absence of focal neurologic deficit, normal level of alertness, no evidence of intoxication, AND absence of other clinically apparent pain which could distract patient from the pain of a cervical injury?
This is the most common form of pediatric scoliosis.
What is idiopathic scoliosis?
It can be assumed that children being evaluated by this type of specialist have failed a reasonable trial of conservative treatment.
What is a pediatric spine surgeon?
Only this imaging can be performed for noted indications regarding spondylolysis.
What is MRI wo of the symptomatic spine level or SPECT Radiopharmaceutical Localization Imaging or SPECT/CT or CT wo of the symptomatic spine level?
The timeframe for follow-up imaging regarding spinal infection in the pediatric patient.
What is there is no timeframe for follow-up imaging?
This imaging can be approved when there is suspected child abuse and intravenous access will already be present for anesthesia administration and there is no contraindication for using contrast.
What is MRI brain wwo, MRI cervical spine wwo, MRI thoracic spine wwo, and MRI lumbar spine wwo?
MRI wo of the entire spine can be approved in these circumstances.
What is when one of the clinical features listed in the guideline are present or if imaging is requested for individuals who are being actively evaluated for corrective surgery?