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Updated: May 25, 2025
A Neonatal Mouse Spinal Cord Compression Injury Model
Published on: March 27, 2016
Comparison of cervical versus thoracic spinal cord injury outcomes in pediatric trauma patients
Alice M Martino1, Areg Grigorian1,2, Catherine M Kuza3
1Department of Surgery, University of California Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Insights
Pediatric cervical spinal cord injury (SCI) is linked to higher mortality, while thoracic SCI involves greater injury severity. Understanding these differences is crucial for improving outcomes in pediatric trauma patients.
Area of Science:
- Trauma Surgery
- Pediatric Neurosurgery
- Spinal Cord Injury Research
Background:
- Spinal cord injury (SCI) in pediatric trauma patients (PTPs) presents unique challenges.
- Comparing outcomes based on injury level (cervical vs. thoracic SCI) is essential for targeted treatment and prognostication.
Purpose of the Study:
- To investigate differences in mortality, length of stay (LOS), and injury severity between pediatric patients with cervical SCI and thoracic SCI.
- To identify independent risk factors for mortality and prolonged ventilation in PTPs with SCI.
Main Methods:
- Analysis of the 2017-2021 Trauma Quality Improvement Program database for PTPs aged 17 and younger with cervical or thoracic SCI.
- Bivariate analyses to compare outcomes between cervical and thoracic SCI groups.
- Logistic regression models to determine independent risk factors for death and prolonged ventilation.
Main Results:
- Cervical SCI was associated with significantly higher mortality (13% vs. 6.1%) and a nearly fourfold increased risk of death.
- Thoracic SCI had higher median Injury Severity Scores (ISS) (25 vs. 16) but decreased hospital LOS (5 vs. 9 days).
- Motor vehicle collisions were the leading cause for both injury types; both groups showed high rates of positive drug screens.
Conclusions:
- Pediatric patients with cervical SCI face a substantially higher risk of mortality compared to those with thoracic SCI.
- Thoracic SCI is associated with greater injury severity, while cervical SCI presents a higher risk of death and prolonged ventilation.
- These findings aid in prognostication and inform injury prevention strategies for pediatric SCI.
Purpose:
To explore differences based on level of pediatric spinal cord injury (SCI), we compared cervical and thoracic SCI in pediatric trauma patients (PTPs), hypothesizing higher mortality and length of stay (LOS) for cervical SCI.
Methods:
The 2017-2021 Trauma Quality Improvement Program was queried for all PTPs ≤ 17 years-old with cervical or thoracic SCI. Bivariate analyses compared the two groups. The primary outcome was mortality and secondary outcomes included hospital LOS and injury severity scores (ISS). Logistic regression models were used to determine independent risk factors for death and prolonged ventilation.
Results:
Of 5280 PTPs, 2538 (65.9%) had cervical SCI and 1316 (34.1%) had thoracic SCI. Motor vehicle collisions were the most common cause of both cervical and thoracic SCI (37.8 and 41.9%). PTPs with thoracic SCI had higher rates of positive drug screen as compared to cervical SCI (39.2 vs 29.8%, p = 0.001). PTPs with thoracic SCI had higher median ISS (25 vs 16, p < 0.001), while cervical SCI had higher mortality (13 vs 6.1%, p < 0.001) but decreased hospital LOS (median 9 vs 5 days, p < 0.001. Cervical SCI were associated with a nearly fourfold increase in the risk of death (95% CI 2.750-5.799, p < 0.001) and a 1.6-fold increase in the risk of prolonged ventilator requirement (95% CI 1.228-2.068, p < 0.001).
Conclusions:
PTPs with cervical SCI have higher mortality while those with thoracic SCI have higher ISS and hospital LOS. Cervical SCI were associated with a fourfold higher risk of death. MVC was the most common cause of injury, and both groups had high rates of positive drug screens. Understanding differing outcomes may assist providers with prognostication and injury prevention.
