Paediatric cervical spine injuries: An audit of 22 acute injuries and literature review

Watson, G. R.; Upadhyay, Vipul

doi:10.1016/j.injury.2005.03.024

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…In an audit of 22 acute injuries by Watson et al, the only child who died had an associated severe head injury. 19 The mortality rate in our study was 4.5%, which is much lower than in other published series. 6,19 All children who died were between the ages of 3 and 5 years and had severe CHIs.…”

Section: Discussioncontrasting

confidence: 65%

An epidemiology of paediatric cervical spine injuries at the Red Cross War Memorial Children's Hospital over a ten-year period

Noconjo

Horn

2020

SA orthop. j

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Background: Paediatric cervical spine injury (CSI) is rare compared to adult CSI. Very little has been published regarding the epidemiology and outcome of CSI in children in South Africa. The objective of this retrospective study is to characterise the epidemiology and report on the outcome of CSI in children <13 years at a tertiary referral centre for paediatric trauma. Methods: We performed a retrospective study of CSI at our hospital over a ten-year period. The Picture Archiving and Communication System (PACS) of our institution was searched for patients with CSIs. Search terms included: cervical spine fracture, subluxation, dislocation, contusion, SCIWORA (spinal cord injury without radiographic abnormality) and retroclival haematoma. Demographic and clinical data were obtained from hospital records. Injury-related variables were compared for children ≤8 and >8 years due to anatomical and biomechanical differences observed. Outcome was assessed using the Frankel grading. Results: Sixty-six children were identified with a cumulative incidence of 0.1%. The median age was 7 years (inter-quartile range 4-8.8) and 65% were male. All injuries were caused by blunt trauma. Passenger motor vehicle injury (MVA) accounted for 52% of injuries. Injuries due to physical abuse, and recreational and sporting activities did not occur. Children ≤8 years of age incurred more injuries than those >8 years (74.2% vs 25.8%). Ninety-eight per cent of injuries occurred in the upper cervical spine (C1-C4) of children ≤8 years. Of the 13 (19.6%) children with neurologic injury, five (7.5%) had complete spinal cord injury, four (6%) had incomplete neurology, and three (4.5%) died. SCIWORA occurred in six (9%) children with variable outcome. Seven patients (10.6%) were operated for instability. An injury severity score (ISS) of 25 (13-34) was associated with poor outcome. The mortality rate was 4.5% and all children who died were ≤8 years with upper CSIs and closed head injuries (CHIs) related to MVA. Conclusion: CSI occurred in 0.1% of patients evaluated following trauma. MVAs, either pedestrian or passenger, were responsible for the majority of these injuries. Children ≤8 years were more frequently injured and sustained injuries to the upper cervical spine. The majority of paediatric CSIs are stable injuries that can be managed conservatively; however, urgent surgical stabilisation is indicated for unstable injuries. CSI with associated CHI caused by MVAs in young children is associated with death. Even though our patients are referred from high violence communities, no CSIs were attributed to physical abuse or penetrating injury.

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Section: Discussioncontrasting

confidence: 65%

An epidemiology of paediatric cervical spine injuries at the Red Cross War Memorial Children's Hospital over a ten-year period

Noconjo

Horn

2020

SA orthop. j

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“…However, the results of this study were widely criticized as inaccurate . There have been some studies documenting the occurrence of cervical spine injuries from falls (Chiaviello, 1994;Schwartz, 1997;Watson, 2005). Schwartz reviewed records from four major hospitals over an average span of 11 years and found only 41 cases of cervical spine injury.…”

Section: B Neck Injury Riskmentioning

confidence: 99%

Investigation of head and neck injury risk associated with short-distance falls in 12 month old children.

Knight

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guided me through this process and taught me so much, but made this an enjoyable experience as well. With her help, I have grown both professionally and personally. I would also like to thank Dr. Mary Clyde Pierce for her insight into the clinical problem that inspired this project and for helping me see the importance of this research and its iv ABSTRACT The purpose of this study was to determine the risk of severe head and neck injury in short distance falls for a 12-month-old child. A series of free falls and falls from standing were experimentally simulated using an instrumented anthropomorphic test device (ATD) representing a 12-month-old child. Three different falls heights, five different impact surfaces, and two levels of joint stiffness were tested to determine their effect on injury risk. Linear head accelerations were measured and angular head accelerations were calculated using the base of the neck as the pivot point. Head Injury Criteria (HIC) values and impact durations were also determined for each fall. Neck loads were measured and used to compute N ij values to be compared with injury thresholds.The falls from standing generally were associated with a greater head injury risk than the free falls. In the free falls, ground-based falls were associated with a greater head injury risk than the higher fall heights tested. However, for the falls from standing, greater falls heights were associated with a greater head injury risk. Head injury risk also increased with stiffer surfaces and was greater for tightened joints than for joints adjusted to normal specifications. Neck injury risk also tended to increase with greater fall

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Blunt cervical spine injury in children

Tilt¹,

Babineau²,

Fenster³

et al. 2012

Current Opinion in Pediatrics

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Paediatric cervical spine injuries: An audit of 22 acute injuries and literature review

Cited by 3 publications

References 14 publications

An epidemiology of paediatric cervical spine injuries at the Red Cross War Memorial Children's Hospital over a ten-year period

An epidemiology of paediatric cervical spine injuries at the Red Cross War Memorial Children's Hospital over a ten-year period

Investigation of head and neck injury risk associated with short-distance falls in 12 month old children.

Blunt cervical spine injury in children

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