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Pediatric Cervical Spine Trauma: A Narrative Review
Justin K Zhang1, Natasha Hongsermeier-Graves, Boris Savic
1Department of Neurosurgery, University of Utah Health, Salt Lake City, UT.
Insights
Pediatric cervical spine trauma requires early diagnosis and understanding of unique anatomy for effective management. Standardized protocols aid in treatment decisions for these injuries, which affect 1-2% of pediatric trauma cases.
Area of Science:
- Pediatric Orthopedics
- Neurosurgery
- Trauma Surgery
Background:
- Pediatric cervical spine trauma can lead to severe morbidity, mortality, and neurological deficits.
- Unique anatomical characteristics of the developing pediatric cervical spine increase susceptibility to injury.
Purpose of the Study:
- To present an updated review of pediatric cervical spine trauma.
- To highlight key aspects of diagnosis and management in children.
Main Methods:
- A narrative review of the literature.
- Searches conducted in PubMed and EMBASE databases for pediatric cervical spine trauma.
Main Results:
- Pediatric cervical spine injuries account for 1-2% of all pediatric trauma cases.
- Motor vehicle collisions are the primary cause, with sports injuries more prevalent in older children.
- Anatomical factors like larger head-to-body ratio predispose younger children to higher cervical spine injuries.
- Standardized protocols and classification systems (e.g., Pediatric Cervical Spine Clearance Working Group, AO Spine) are crucial for triage and management decisions.
- Surgical principles are similar to adults, with modern techniques achieving high fusion rates.
Conclusions:
- Early and accurate diagnosis is essential for effective management of pediatric cervical spine injuries.
- A comprehensive understanding of pediatric spinal anatomy is critical.
- A versatile surgical armamentarium is necessary for optimal treatment outcomes.
Study Design:
Narrative review.
Objective:
To provide an updated overview of pediatric cervical spine trauma.
Summary Of Background Data:
Pediatric cervical spine trauma can cause debilitating morbidity and mortality and neurological impairment. The unique anatomic features of the developing cervical spine can predispose children to injuries.
Methods:
We reviewed the pediatric cervical spine trauma literature in PubMed and EMBASE.
Results:
Pediatric cervical spine injury occurs in 1%-2% of pediatric trauma. The most frequent cause is motor vehicle collisions, with sports-related injuries being more common in older children. Larger head-to-body ratios and tissue elasticity can predispose young children to a greater risk of injury higher in the craniocervical junction and cervical spine. Standardized protocols and classification systems, such as the Pediatric Cervical Spine Clearance Working Group protocol and the AO Spine Injury and Subaxial Cervical Spine Injury Classifications, are valuable in triage as well as for assessing the need for operative versus nonoperative management. In general, operative approaches and principles are similar to those in adults, with modern instrumentation and fusion techniques achieving high rates of successful arthrodesis.
Conclusions:
Effective management and treatment of pediatric cervical spine injuries depends on early and accurate diagnosis, a thorough understanding of pediatric spinal anatomy, and a versatile surgical armamentarium.
