Cervical spine injury patterns in children

Area of Science:

• Pediatric Emergency Medicine
• Orthopedic Surgery
• Trauma Surgery

Background:

• Pediatric cervical spine injuries (CSIs) are rare and present differently than adult injuries.
• Understanding these differences is crucial for accurate diagnosis and management.

Purpose of the Study:

• To characterize the patterns, treatments, and outcomes of CSIs in a large pediatric cohort.
• To identify age- and mechanism-related variations in pediatric CSIs.

Main Methods:

• Retrospective review of 540 children (<16 years) with CSIs across 17 hospitals.
• Analysis of injury patterns, mechanisms, and treatments stratified by age groups (<2, 2-7, 8-15 years).
• Logistic regression used to explore associations between injury characteristics and outcomes.

Main Results:

• Cervical spine injury (CSI) patterns varied significantly with age and mechanism.
• Younger children (<7 years) predominantly sustained injuries from motor vehicle crashes (MVCs) affecting the upper cervical spine (occiput-C2).
• Older children (8-15 years) had injuries from sports and MVCs, with a higher proportion of subaxial (C3-C7) involvement; 21% experienced neurologic deficits, and 7% died.

Conclusions:

• Pediatric cervical spine injuries (CSIs) exhibit considerable variability in presentation, treatment, and outcomes.
• The rarity, diverse patterns, and significant morbidity underscore the importance of timely recognition and intervention for pediatric CSIs.