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Frequency of Cervical Spine Injuries in Pediatric Craniomaxillofacial Trauma

Helen Xun1, Joseph Lopez2, Halley Darrach1

  • 1Medical Student, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|March 27, 2019
PubMed

Insights

Cervical spine injuries (CSIs) are rare in pediatric patients with craniomaxillofacial (CMF) fractures, occurring in only 0.169% of cases. This study highlights the low incidence and supports conservative imaging for children with deciduous teeth.

Area of Science:

  • Pediatric Traumatology
  • Orthopedic Surgery
  • Emergency Medicine

Background:

  • Cervical spine injury (CSI) evaluation is critical in pediatric patients with craniomaxillofacial (CMF) trauma.
  • Limited research exists on CSI frequency within this specific pediatric population.

Purpose of the Study:

  • To determine the incidence of concurrent CSI in pediatric patients presenting with CMF fractures.
  • To analyze the correlation between CMF fracture patterns and CSI in children.

Main Methods:

  • Retrospective cohort study of pediatric patients with CMF fractures at Johns Hopkins Hospital ED (1990-2010).
  • Chart review for mechanism of injury, CSI details, CMF fracture patterns, and outcomes.
  • Statistical analysis to identify correlations and significance.

Main Results:

  • 2,966 pediatric patients with CMF fractures were identified; 5 (0.169%) had concomitant CSIs.
  • CSI incidence varied by dentition: 0% (deciduous), 0.307% (mixed), 0.441% (permanent).
  • CSIs were associated with middle-third facial, upper-third cranial, and lower-third cranial fractures.

Conclusions:

  • CSI is rare in pediatric CMF fractures (0.169%), significantly lower than adult rates (3.69-24%).
  • No CSIs were found in pediatric patients with deciduous dentition.
  • Anatomic differences may explain the low CSI rate, supporting conservative imaging in this group.
Abstract

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