[Severe injuries of the cervical spine in childhood, an interdisciplinary consideration]

Since 1976 in the department of pediatric surgery in Heidelberg we treated five fractures of the cervical spine with luxation, three patients demonstrated a high spinal lesion with tetraplegia. During the past five years eight subluxations were hospitalised. In this paper we relate the various injury mechanisms and fracture forms; especially the typical lesions of the altanto-axial region are discussed. The importance of modern imaging techniques, including NMR, as well as the age- and situation-dependent therapy are detailed. Based on a case report on a four year old boy with upper cervical spine lesion and tetraplegia medical nursing and logistic problems are discussed. Incentives of intensive care albeit limited, in pediatric surgical and pediatric anaesthesiological departments, not specialised in the management of tetraplegia, are pointed out.