Sir.—Rachesky et al1 have outlined a two-variable clinical assessment model for the prediction of cervical spine injury in child trauma victims. They achieved 100% sensitivity by using "EITHER a complaint of neck pain OR involvement in a vehicular accident with head trauma" to identify their 25 victims. Rachesky et al caution against accepting this model until further studies confirm their results. We would add further caution to this recommendation after applying their twovariable clinical assessment model to our own series of 59 child cervical spine trauma victims, as outlined below.
Patients and Methods.—We have retrospectively evaluated 84 variables (demographic, circumstances of injury, and clinical information) on 59 child trauma victims who were 16 years of age or younger and who had roentgenographically proven cervical spine injuries or neurologic deficits without roentgenographic abnormality. These children presented for care at either the Children's Memorial Hospital, Chicago, or Northwestern University