Pediatric cervical spine instability

Ghanem, Ismat; Hage, Samer El; Rachkidi, Rami El; Kharrat, Khalil; Dagher, Fernand; Kreichati, Gaby

doi:10.1007/s11832-008-0092-2

Cited by 45 publications

(23 citation statements)

References 98 publications

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“…The horizontal orientation of the facet joints in children along with the relatively lax ligament contribute to the development of cervical kyphosis after posterior surgery [8]. The cervical spine is most prone to develop a deformity after laminectomy in comparison to the thoracic and lumbar regions in paediatric patients [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…A longer follow-up of our cases presenting in the paediatric age group would be prudent in order to check for the development of deformity during the latter part of spinal maturation. Patient age less than 3 years, pre-existing spinal deformity, decompression spanning the axial cervical spine and cervicothoracic region, removal of 3 or more laminae, aggressive facetectomy, presence of an intra- or extradural lesion and myelopathic symptoms are risk factors for developing postsurgical spinal deformity [1,2,3,4,8,18]. Identification of such peri-operative risk factors in children can help a surgeon strategize on whether primary intra-operative spinal fusion or close radiological follow-up is required keeping in mind the growing paediatric spine.…”

Section: Discussionmentioning

confidence: 99%

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Cervical Spine Instability following Resection of Benign Intradural Extramedullary Tumours in Children

2011

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Background: Benign intradural extramedullary (IDEM) tumours in children are usually neural sheath derivatives or are dura based. Total resection of these benign tumours is the primary surgical goal. A management issue related to their occurrence in the growing paediatric spine is a higher propensity for the development of postlaminectomy kyphosis, especially in the upper cervical spine, than what is seen in adults. Methods: A retrospective study was performed on 22 patients to analyse the incidence, presentation and management of postoperative kyphotic deformities in children who underwent laminotomy and tumour excision for benign cervical IDEM tumours. Results: The incidence of postoperative kyphosis was 13%. All these patients underwent subsequent posterior fusion following reduction of the deformity with good results. Conclusion: Following excision of cervical intradural lesions, paediatric patients need to be followed up regularly to rule out the development of postsurgical deformities especially in the upper cervical spine region. Various biomechanical, surgical and tumour-related factors which influence the development of deformities are reviewed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cervical Spine Instability following Resection of Benign Intradural Extramedullary Tumours in Children

2011

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“…En las lesiones traumáticas graves de la columna cervical el paciente puede encontrarse con un nivel Glasgow bajo por asociarse a traumatismo craneal, permanecer en decúbito supino con resistencia a la movilización por el dolor o incluso sujetarse la cabeza con las manos debido a la sensación de inestabilidad. En el caso de la pseudosubluxación C2-C3, el paciente puede estar asintomático o referir molestias, en ocasiones intensas, causada por la contractura de la musculatura paravertebral cervical debido a un antecedente traumático menor 4 . La evaluación radiográfica debe ser sistemática y completa, incluyendo las proyecciones anteroposterior y lateral de toda la columna cervical.…”

Section: Discussionunclassified

Pseudoluxación C2-C3 en la infancia

Tabernero¹,

Sánchez²,

Jiménez³

et al. 2018

Rev Fac Cien Med Univ Nac Cordoba

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Resumen:Las lesiones traumáticas de la columna cervical son infrecuentes en los niños, representando el 1% de las fracturas pediátricas y el 2% de todas las lesiones raquídeas. Es importante conocer que la columna cervical en la infancia presenta variaciones anatómicas que en ocasiones pueden interpretarse como patológicas ya que en los niños una adecuada exploración física muchas veces puede ser complicada. El objetivo de este caso clínico es mostrar un hallazgo radiológico fisiológico de la columna cervical infantil que tiende a ser malinterpretado como patológico: la pseudosubluxación C2-C3.Se presenta un caso de un niño de 5 años de edad que acude a urgencias de traumatología pediátrica de nuestro centro por dolor cervical tras caída desde un tobogán. Se realizan radiografías cervicales de urgencias observando una disrupción de la línea cervical anterior y posterior entre C2 y C3. Una adecuada anamnesis junto con un meticuloso examen clínico y radiológico permite su correcto diagnostico sin necesidad de otras pruebas complementarias. La pseudoluxación anterior de C2 sobre C3 se puede estar presente en el 40% de los niños menores de 8 años. Este hallazgo puede diferenciarse de la luxación traumatic valorando la línea espinolaminar o línea de Swischuk, línea entre el borde anterior de las apófisis espinosas de C1 a C3. La interpretación adecuada de las radiografías de la columna cervical en la infancia requiere del conocimiento de estas variantes radiológicas y de las peculiares características de este segmento vertebral en la edad pediátrica. Palabras clave: pseudosubluxacion C2-C3; infantil, listesis cervical; línea espinolaminal Abstract:Cervical spine injury is rare in children. It is seen primarily in those who sustain significant, severe blunt trauma, occurring in 1 to 2 percent of such cases. The interpretation of cervical spine radiographs and the clinical examination in children may be difficult.The objective of this case clinic is to report on a physiological radiographic finding of the cervical spine in childhood that trends to be misjudged as pathologic: C2-C3 pseudosubluxation. We presented a boy, aged 5 years, who came to our Traumatic pediatric emergency center for cervical pain after falling from a height. In lateral radiographs we observed a disruption of the alignment of the anterior and posterior vertebral body line in C2-C3 space. A detailed anamnesis as well as a meticulous radiological and clinical exploration, allow to establish the right diagnosis in most cases, without any other complementary probe. Pseudosubluxation of C2 anterior to C3 is seen in approximately 40 percent of children under the age of 8 years. Pseudosubluxation can be differentiated from true subluxation by evaluating the spinolaminal line (Swischuk), line between the anterior aspects of the C1 and C3 spinous processes. The suitable radiographic interpretation of the cervical spine in children requires the knowledge of the peculiarities of this segment in the pediatric age.

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“…The single vertebral body ossifi cation center results from coalescence of the C5 C5 C5 C6 C6 C6 C7 C7 C7 C8 C8 T1 T1 T1 T2 T2 T2 T3 T3 T3 Spinal cord ( 2 ) appear by the seventh to ninth fetal week and are separated from the body by the neurocentral synchondroses ( 3 ), which close between 3 and 7 years of age. The posterior synchondrosis ( 4 ) between the spinous processes usually closes by age 2-4 years. Superior and inferior epiphyseal rings ( 5 ) appear at puberty, contribute to the vertical growth of the vertebral body, and unite with it at about age 25 years (Reprinted from Ghanem et al [ 4 ] with kind permission from Springer Science and Business Media) two chondral centers that are transiently present (dorsal-ventral or side-by-side), which helps explain the occurrence of posterior and lateral hemivertebrae.…”

Section: Normal Developmentmentioning

confidence: 99%

“…The posterior synchondrosis ( 4 ) between the spinous processes usually closes by age 2-4 years. Superior and inferior epiphyseal rings ( 5 ) appear at puberty, contribute to the vertical growth of the vertebral body, and unite with it at about age 25 years (Reprinted from Ghanem et al [ 4 ] with kind permission from Springer Science and Business Media) two chondral centers that are transiently present (dorsal-ventral or side-by-side), which helps explain the occurrence of posterior and lateral hemivertebrae. The strip of cartilage that separates the two neural arch centers from the single vertebral centrum, the neurocentral synchondrosis, is slightly anterior to the base of the pedicles (Fig.…”

Section: Normal Developmentmentioning

confidence: 99%

The Spine: Congenital and Developmental Conditions

Taragin

Wootton‐Gorges

2014

Pediatric Orthopedic Imaging

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The chapter initially discusses normal spinal development and variants. Pathology is addressed fi rst in terms of general structural vertebral anomalies. These are then applied to congenital scoliosis, kyphosis, and lordosis, as well as anomalies involving the craniovertebral junction. Discussion of spinal dysraphism follows, including tethered fi lum terminale, hydrosyringomyelia, and diastematomyelia. Congenital intraspinal tumors are briefl y reviewed. Klippel-Feil syndrome and caudal regression are presented, as well as spine manifestations of neurofi bromatosis and several other syndromes. Idiopathic scoliosis is discussed in detail, including curve measurement, imaging techniques, and treatment options. Neuromuscular scoliosis is briefl y reviewed. The chapter concludes with juvenile kyphosis.

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Pediatric cervical spine instability

Cited by 45 publications

References 98 publications

Cervical Spine Instability following Resection of Benign Intradural Extramedullary Tumours in Children

Cervical Spine Instability following Resection of Benign Intradural Extramedullary Tumours in Children

Pseudoluxación C2-C3 en la infancia

The Spine: Congenital and Developmental Conditions

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