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Pediatric multilevel spine injuries: an institutional experience
Martin M Mortazavi1, Seref Dogan, Erdinc Civelek
1Division of Neurological Surgery, and Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Summary
Multilevel spine injuries in children are most common in adolescents aged 9-16, primarily affecting the cervical region. Management principles for these injuries mirror those for single-level spinal trauma, guided by stability and neurological status.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Trauma Surgery
Background:
- Spinal column trauma is rare in children (1-2% of fractures).
- Pediatric spinal injuries can affect multiple vertebral levels.
- Understanding injury patterns is crucial for effective management.
Purpose of the Study:
- To evaluate injury mechanisms and patterns in pediatric multilevel spine injuries.
- To identify factors influencing management and outcomes.
- To analyze treatment strategies for pediatric spinal trauma.
Main Methods:
- Retrospective review of 183 pediatric spine injury patients.
- Analysis of 48 patients with multilevel spinal injuries (mean age 12.8 years).
- Categorization of injuries by level (contiguous/noncontiguous) and region (cervical, thoracic).
Main Results:
- Multilevel injuries occurred in 26.2% of patients, predominantly in those aged 9-16.
- Cervical spine was the most frequently involved region (31.2%).
- Most patients (73%) remained neurologically intact; 8.3% had complete spinal cord injury (SCI).
- Conservative treatment was used in 75% of cases; 25% underwent surgery.
- Mortality rate was 6.2%.
Conclusions:
- Pediatric multilevel spine injuries are most prevalent in older children (9-16 years) and often involve the cervical spine.
- The upper (rostral) injury is frequently linked to neurological deficits.
- Treatment decisions for multilevel spine injuries should prioritize spinal stability and neurological status, similar to single-level injuries.
