Related Experiment Video
Updated: Aug 11, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Pediatric cervical spine injuries-results of the German multicenter CHILDSPINE study
Jan-Sven Jarvers1, Christian Herren2, Matthias K Jung3
1Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Germany. jan-sven.jarvers@medizin.uni-leipzig.de.
Insights
This study analyzed pediatric cervical spine injuries in Germany, finding upper spine injuries more common in younger children and subaxial injuries in older ones. Most cases were treated conservatively.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Epidemiology
Background:
- Cervical spinal trauma in children is a significant concern.
- Understanding epidemiological data is crucial for effective diagnosis and treatment strategies.
- Previous data on pediatric cervical spine injuries in Germany is limited.
Purpose of the Study:
- To provide comprehensive epidemiological data on pediatric cervical spine trauma in Germany.
- To inform future clinical decision-making regarding diagnosis and therapy for pediatric cervical spine injuries.
- To analyze injury patterns, mechanisms, and outcomes in different pediatric age groups.
Main Methods:
- Retrospective multicenter study involving six German spine centers.
- Inclusion of pediatric patients (up to 16 years) with cervical spine injuries treated between 2010 and 2016.
- Analysis of trauma mechanisms, injury levels, accompanying injuries, diagnostic imaging, and treatment, stratified by age groups (0-6, 7-9, 10-16 years).
Main Results:
- 214 children with 265 cervical spine injuries were identified.
- Falls and traffic accidents were the leading causes across all age groups.
- Younger children (0-9 years) predominantly sustained upper cervical spine (C0-C2) injuries, while older children (10-16 years) had more subaxial injuries.
- Distortion/whiplash was the most frequent injury type (68.2%); neurological deficits were rare.
- Head injuries were the most common accompanying injuries (39.8%).
Conclusions:
- Pediatric cervical spine injury patterns vary significantly with age, with younger children affected in the upper cervical spine and older children in the subaxial regions.
- Conservative treatment was the predominant approach for the majority of cases (84.1%).
- Approximately 15.9% of pediatric patients required surgical intervention for cervical spine injuries.
Objectives:
The aim of this study was to provide epidemiological data of pediatric patients suffering from cervical spinal trauma in Germany, in order to integrate these data in future decision-making processes concerning diagnosis and therapy.
Materials And Methods:
Retrospective multicenter study includes all patients up to 16 years suffering from cervical spine injuries who were treated in six German spine centers between 01/2010 and 12/2016. The clinical databases were screened for specific trauma mechanism, level of injury as well as accompanying injuries. Diagnostic imaging and the chosen therapy were analyzed. Patients were divided into three age groups for further evaluation: age group I (0-6 years), age group II (7-9 years), age group III (10-16 years).
Results:
A total of 214 children with 265 cervical spine injuries were included during the mentioned period. The mean age at the time of injury was 11.9 (± 3.9) years. In age group I, 24 (11.2%) patients were included, age group II consisted of 22 patients (10.3%), and 168 patients belonged to age group III (78.5%). Girls and boys were equally affected. In all age groups, falls and traffic accidents were the most common causes of cervical spine injuries. A total of 180 patients (84.1%) were treated conservatively, while 34 (15.9%) children underwent surgery. Distorsion/whiplash injury was the most common entity (n = 165; 68.2%). Children aged 0-9 years had significantly (p < 0.001) more frequent injuries of the upper cervical spine (C0-C2) compared to older age groups. Patients of age group III were more likely to suffer from injuries in subaxial localizations. Neurological deficits were rarely seen in all age groups. Head injuries did represent the most common accompanying injuries (39.8%, n = 92).
Conclusions:
The upper cervical spine was more frequently affected in young children. Older children more often suffered from subaxial pathologies. The majority of cervical spinal column injuries were treated conservatively. Nevertheless, 15% of the hospitalized children had to be treated surgically.
