Traumatic ligamentous instability of the cervical spine in children

Sixteen cases of dislocation and ligamentous disruptions of the cervical spine in children are reported. In five cases resulting from injury to the upper cervical spine, the roentgenographical features of the instability at the C1-C2 level are documented and their therapeutic orientation is defined. Eleven injuries were of the lower cervical spine: three dislocations, two of which were old cases, and eight serious ligamentous disruptions. Diagnosis of serious ligamentous disruptions was based on precise radiographic criteria: increase of the interspinous distance, loss of parallelism between the articular processes, and posterior widening of the disc space. The indications for surgical fixations in serious ligamentous disruptions depend on persistence of the clinical and radiological signs after a long orthopedic immobilization.