Spinal injuries in children

doi:10.1016/j.jpedsurg.2003.12.011

Journal of Pediatric Surgery

Volume 39, Issue 4, April 2004, Pages 607-612

https://doi.org/10.1016/j.jpedsurg.2003.12.011 Get rights and content

Abstract

Background/purpose

Traumatic spinal injury (TSI) is an uncommon source of morbidity and mortality in children. The aim of this study was to describe childhood TSI in a single level 1 urban pediatric trauma center.

Methods

The authors retrospectively analyzed all children younger than 14 years with TSI, treated at a level I pediatric trauma center between 1991 and 2002 (n = 406, 4% total registry). All children were stratified according to demographics, mechanisms, type and level of injury, radiologic evaluations, associated injuries, and mortality.

Results

The mean age was 9.48 ± 3.81 years. The most common overall mechanism of injury was motor vehicle crash (MVC; 29%) and ranked highest for infants. Falls ranked highest for ages 2 to 9 years. Sports ranked highest in the 10 to 14 year age group. Paravertebral soft tissue injuries were 68%. The most common injury level was the high cervical spine (O-C4). The incidence of spinal cord injury without radiologic abnormality (SCIWORA) was 6%. Traumatic brain injury (37%) was the most common associated injury. Overall mortality rate was 4% in this urban catchment.

Conclusions

TSI in children requires a different preventive and therapeutic logarithm compared with that of adults. The potential devastating nature of TSI warrants that the health care team always maintains a high index of suspicion for injury. Future prospective studies are needed to further elucidate injury patterns.

Section snippets

Materials and methods

After institutional IRB approval at the Johns Hopkins Hospital, a level I urban trauma center, data were obtained from the pediatric trauma registry, a comprehensive database of approximately 12,000 consecutively injured children from 1991 to 2002.

All children age 14 and younger with spinal trauma diagnoses, defined by International Classification of Diseases 9th Revision, Clinical Modification (ICD-9-CM) codes ranging from 805.0 to 806.9 and also 839.0 to 839.9 and 847.0 to 847.9 were included

Results

Five characteristics were used to evaluate the children with spinal injuries. The definitions of patient groups, etiologies, injury levels, SCIWORA, and associated injuries were standard well accepted literature parameters used to evaluate injury data.7, 8, 11, 12, 13, 14

Discussion

Traumatic spinal injuries in children are uncommon, representing only 1% to 10% of all reported spinal injuries. Each year, approximately 1,000 new spinal injuries are reported in children.15 The true incidence of TSI may be underestimated because of scene mortality or death in transport. It is estimated that 5% of the catchment of trauma centers caring for children less than 16 years of age will consist of vertebral column or spinal cord injuries.16, 17, 18, 19 In our study, spinal injury

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Spinal injuries in children

Abstract

Background/purpose

Methods

Results

Conclusions

Section snippets

Materials and methods

Results

Discussion

Pediatr Clin North Am

Neurosurg Clin North Am

J Pediatr Surg

Orthop Clin North Am

J Pediatr Surg

J Pediatr Surg

Am J Emerg Med

Am J Emerg Med

Functional improvement after pediatric spinal cord injury

Am J Physic Med Rehabil

Pediatric thoracic trauma

Crit Care Med

Pediatric spinal injuryThe very young

J Neurosurg

Cervical spine injury in child abuseReport of two cases

Pediatr Radiol

Epidemiology and prevention of childhood injuries

Crit Care Med

Spinal trauma in children

Pediatr Radiol

Pediatric spine and spinal cord cord trauma. State of the art for the third millennium

Child’s Nerv Syst

A prospective multicenter study of crvical spine injury in children

Pediatrics

Spinal injuries in the pediatric age groupA review of 82 cases of spinal cord and vertebral column injuries

Eur Spine

Epidemiology of incident spinal fracture in a complete population

Spine

The global burden of injuries

Am J Public Health

Pediatric spinal injuryReview of 174 hospital admissions

J Neurosurg

Etiology of children’s spinal injuries at RanchoLosAmigos

Spine

Spinal injury in childrenA review of 156 cases seen from 1950 through 1978

Mayo Clin Proc