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Updated: Oct 9, 2026
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Characteristics of pediatric cervical spine injuries
E R Kokoska1, M S Keller, M C Rallo
1Division of Pediatric Surgery, Department of Surgery, Saint Louis University Health Sciences Center and Cardinal Glennon Children's Hospital, St Louis, MO 63104, USA.
Insights
Blunt cervical spine trauma is rare in children, with injury patterns differing by age. While major neurologic sequelae are uncommon in survivors, younger children face higher mortality risks.
Area of Science:
- Pediatric Traumatology
- Orthopedic Surgery
- Neurology
Background:
- Cervical (C) spine trauma in children is a critical concern.
- Understanding injury mechanisms and outcomes is vital for effective management.
Purpose of the Study:
- To assess the mechanisms, patterns of injury, and outcomes in pediatric patients with cervical spine trauma.
- To analyze age-related differences in C-spine injuries.
Main Methods:
- Retrospective review of the National Pediatric Trauma Registry (April 1994-March 1999).
- Identification of blunt trauma victims with cervical fractures, dislocations, or spinal cord injuries without radiographic abnormality (SCIWORA) using ICD-9 criteria.
Main Results:
- 1.6% of pediatric trauma entries involved blunt C-spine injury (n=408).
- Motor vehicle accidents (44%), sports (16%), and pedestrian incidents (14%) were leading causes.
- Younger children (<10 years) had higher rates of high C-spine injuries (C1-C4), dislocations, and cord injuries, with increased mortality (30% vs. 7%).
- Neurologic sequelae were uncommon in survivors, with complete cord lesions being rare (4%).
Conclusions:
- Blunt C-spine injuries in children are infrequent, with injury patterns significantly influenced by age.
- Major neurologic deficits in survivors are uncommon and rarely complete.
- Age-specific data are crucial for understanding and managing pediatric cervical spine trauma.
Purpose:
The objective of this study was to assess the mechanisms and patterns of injury and outcome in children with cervical (C) spine trauma.
Methods:
We reviewed the National Pediatric Trauma Registry between April 1994 and March 1999 and identified (by ICD-9 criteria) all cases of blunt trauma victims with cervical fractures, dislocations, and spinal cord injuries without radiographic abnormality (SCIWORA). Data are shown as mean +/- SEM.
Results:
During the 5-year period, the incidence of blunt C-spine injury was 1.6% (n = 408 of 24,740 total entries). Mean age was 10.5+/-0.3 (1 to 20) years, and 59% were boys. Leading mechanisms were motor vehicle accidents (n = 179; 44%), sports (n = 66; 16%), and pedestrian injuries (n = 57, 14%). Younger (< or =10 years) children more often sustained high (C1 to C4) vs low (C5 to C7) injuries (85% v 57%; P<.01) and also had a higher incidence of dislocations (31% v 20%; P<.01) and cord injuries (26% v 14%; P<.01), whereas older children had more C-spine fractures (66% v 43%; P<0.01). Mortality rates (overall, 17%) were higher in younger children (n = 180) when compared with older children (n = 228; 30% v 7%; P<.01). Overall, the majority of deaths (93%) were associated with brain injuries. No children with cervical dislocations had neurologic sequelae. The preponderance of children with fractures (83%) also were without neurologic injury, whereas those associated with SCIWORA usually were (80%) partial. Overall, complete cord lesions were infrequent (4%).
Conclusions:
These data, representing the largest series to date, confirm that blunt C-spine injuries in children are rare. Patterns of injury vary significantly according to child age. Major neurologic sequelae in survivors is uncommon, does not correlate well with cord level, and rarely is complete.
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