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Published on: March 27, 2016
Spinal injuries in children
Bayram Cirak1, Suzan Ziegfeld, Vinita Misra Knight
1Pediatric Division, Department of Neurosurgery; Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Insights
Childhood traumatic spinal injury (TSI) is uncommon but serious. Motor vehicle crashes are the leading cause in infants, falls in toddlers, and sports in older children, highlighting the need for tailored prevention.
Area of Science:
- Pediatric Traumatology
- Spinal Cord Injury Research
- Public Health & Injury Prevention
Background:
- Traumatic spinal injury (TSI) is a rare but significant cause of childhood morbidity and mortality.
- Understanding pediatric TSI is crucial for developing effective management strategies.
Purpose of the Study:
- To characterize the epidemiology of childhood TSI.
- To describe injury patterns, mechanisms, and outcomes in children treated at a pediatric trauma center.
Main Methods:
- Retrospective analysis of 406 children under 14 years with TSI treated between 1991 and 2002.
- Stratification by demographics, injury mechanisms, injury type/level, associated injuries, and mortality.
Main Results:
- Mean age was 9.48 years; motor vehicle crashes (MVCs) were the most common mechanism overall (29%).
- Falls predominated in younger children (2-9 years), sports in adolescents (10-14 years).
- High cervical spine injuries (O-C4) were most frequent; spinal cord injury without radiologic abnormality (SCIWORA) occurred in 6%; traumatic brain injury (TBI) was the most common associated injury (37%).
Conclusions:
- Pediatric TSI management requires distinct approaches compared to adults.
- A high index of suspicion is essential for healthcare teams managing potential TSI in children.
- Further prospective research is needed to refine understanding of TSI patterns in children.
Background/Purpose:
Traumatic spinal injury (TSI) is an uncommon source of morbidity and mortality in children. The aim of this study was to describe childhood TSI in a single level 1 urban pediatric trauma center.
Methods:
The authors retrospectively analyzed all children younger than 14 years with TSI, treated at a level I pediatric trauma center between 1991 and 2002 (n = 406, 4% total registry). All children were stratified according to demographics, mechanisms, type and level of injury, radiologic evaluations, associated injuries, and mortality.
Results:
The mean age was 9.48 +/- 3.81 years. The most common overall mechanism of injury was motor vehicle crash (MVC; 29%) and ranked highest for infants. Falls ranked highest for ages 2 to 9 years. Sports ranked highest in the 10 to 14 year age group. Paravertebral soft tissue injuries were 68%. The most common injury level was the high cervical spine (O-C4). The incidence of spinal cord injury without radiologic abnormality (SCIWORA) was 6%. Traumatic brain injury (37%) was the most common associated injury. Overall mortality rate was 4% in this urban catchment.
Conclusions:
TSI in children requires a different preventive and therapeutic logarithm compared with that of adults. The potential devastating nature of TSI warrants that the health care team always maintains a high index of suspicion for injury. Future prospective studies are needed to further elucidate injury patterns.
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