Assessment of atraumatic back and spine conditions in children

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed assessment of atraumatic back and spine conditions in children with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Clinical signs of spinal nerve root or spinal cord compression associated with rapidly progressive neurological signs or symptoms or suspected cauda equina syndrome

If the child is unable to ambulate or move the spine

New diagnosis of spinal tumour with neurological deficits

Suspected spinal infection (e.g. child is unwell, listless, flushed, anorexic or is febrile)

Routine referral criteria

Determine Category 2 or 3 urgency.

Severe or progressive low back pain that has persisted for longer than 6 weeks with functional impairment or sleep disturbance, that has been unresponsive to medical management

Symptomatic spondylolysis or spondylolisthesis with more than 50 percent slippage in a child younger than 16 years

Kyphosis — thoracic kyphosis greater than 60 degrees

Kyphosis — kyphosis of the lumbar spine

Kyphosis — short or sharp kyphosis with any underlying congenital spinal anomaly

Kyphosis — in a child younger than 18 years with associated underlying conditions (e.g. neurofibromatosis, achondroplasia)

Scoliosis in a child — younger than 13 years with Cobb angle greater than 10 degrees

Scoliosis in a child — 13 to 17 years with Cobb angle greater than 20 degrees

Scoliosis in a child — younger than 18 years with associated underlying conditions (e.g. neuromuscular conditions, chromosomal or genetic abnormality)

Usually managed in primary care

Back pain without radiologic abnormality or radicular symptoms
Spondylolisthesis with less than or equal to 50 percent slippage
Thoracic kyphosis less than or equal to 60 degrees
Cobb angle less than or equal to 10 degrees