[Injuries to the cervical spine in children and adolescents]

Lesions of the cervical vertebral column are rare in children. Proper assessment of traumatically conditioned changes is possible only if the physician is fully conversant with the specific characteristics and variations of the normal cervical vertebral column in children. It is difficult to perform differential diagnosis distinguishing between a pseudo subluxation C2/C3 and C3/C4 that is merely a variant of the normal status on the one hand, and a genuine, traumatically conditioned subluxation on the other; likewise, it is difficult to draw a clear diagnostic line between a persistent basal epiphyseal cartilage of the dens axis and a non-dislocated dens fracture. Cervical CT has decisively improved vertebral column diagnostics and has become invaluable. CT examination serves both to help clarify a fracture seen in the plain X-ray in respect of stability or instability, and to definitely confirm or exclude a fracture that appeared to be an uncertain finding. It is from this diagnosis alone that any decision regarding treatment can be taken.