Blunt cervical spine injury in children

Abstract

Evidence in the management of children with CSI has expanded in recent years, but further large prospective studies are needed. We present a review of some recent developments influencing clinical practice.

Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review

“…[177][178][179][180][181] Several low-risk prediction rules have been developed to avoid unnecessary prehospital spinal immobilization in children, but have proven difficult to validate, because these injuries are so uncommon. 186 …”

“…186 Moreover, most of the foundation for prehospital treatment of children with CSIs is based on adult studies, and the evidence favoring current management strategies is therefore even weaker than in adults. 186,187 Pediatric collars are adapted to the size and anatomy of children, whereas undesirable neck flexion on spine boards should be avoided by individual modifications. 188 No studies have been identified that compare spinal stabilization with or without collars in children.…”

“…195 The anatomy and injury patterns observed in children older than 8 years resemble those of adults. 186,194 Younger children have more high-level injuries, fewer fractures, more dislocations, and more SCIs because of their larger head/body ratio, greater ligament laxity, and more horizontal facet joints. 186,191,193,194,196 Outcomes are often poorer in younger than in older children.…”

“…186,194 Younger children have more high-level injuries, fewer fractures, more dislocations, and more SCIs because of their larger head/body ratio, greater ligament laxity, and more horizontal facet joints. 186,191,193,194,196 Outcomes are often poorer in younger than in older children. 191,193 Despite presenting with comparable injury severity, children who undergo prehospital spinal immobilization have higher degrees of pain, are much more likely to undergo radiological examinations, and are more often admitted to hospital than those that are not immobilized.…”

Pediatric Cervical Spine Injuries

“…In these combined cases, dorsal wire fixation is indicated (Fig. 2,4,13,55,56 A form of AARF is known as Grisel syndrome, named after a French ENT surgeon, and it was first described in 1830. 26,37,[52][53][54] Atlanto-axial Rotatory Fixation AARF is the most common PCSI.…”