Roentgen findings in fractures of the vertebral column in childhood Examination of 35 patients and its results

Abstract

In the past 10 years we examined 35 children with fractures of the spine. The most important cause was an injury by a fall from a tree or a climbing stage (23 cases). Traffic accidents or other direct trauma was the cause in 10 patients. Two children had tetanus, The ages of the children range from 2 to 12 years. Clinical symptoms may be diagnostic of vertebral trauma, but quite often symptoms are insignificant or atypical. We detected fractures in every vertebra of the thoracic and lumbar part of the spine. The greatest number of fractures was found between T4 and L2. The typical injury of the spine is a compression fracture of the vertebral body with a wedgeshaped deformity (111 vertebrae); fractures of the transverse processus of lumbar vertebrae were not frequent (10 vertebrae). Other parts of the vertebrae were not involved. The value of scintigraphy in case of doubtful roentgenologic finding is pointed out.

Pediatric Spinal Trauma: Vertebral Column and Spinal Cord Injuries in Children

“…The most notable, the sub dental synchondrosis, is present in all children at age 3 and in 50% at age 5 [13,22,31,49,74,78,79]. It may per sist to the age of 11 [13] and radiographically may be mistaken for an odontoid fracture.…”

“…1). The development of ossification centers, chronology of epiphyseal closure, and details of spinal growth are dis cussed elsewhere [13,17,20,22,26,30,31], The vertebral bodies in the pediatric spine are wedge-shaped, and ver tebrae are primarily cartilaginous. The vertebrae will continue to grow during adolescence.…”

“…Thin-section com puterized tomography (CT) and multiplanar tomogra phy delineate osseous abnormalities. However, plain radiographs, tomography, and CT may have low yields in young children with nonosseous ligamentous or car tilaginous abnormalities [22,23,32], Myelography has traditionally been indicated for the evaluation of acute neural compression; however, magnetic resonance (MR) imaging is best suited for visualizing neural structures and for assessing compressive pathology. MR imaging has been of limited use in acute spinal injury because the resuscitation equipment is incompatible with the mag netic field.…”

“…These normal developmental and growth patterns dic tate a progressive change in the radiographic appear ance of the spine until the osseous characteristics of the adult spine are reached. Until then, the unique vertebral architecture, incomplete ossification, epiphyseal varia tions, and hypermobility can cause uncertainty in the significance of findings on radiographs in children (table 2) [13,20,22,23,26,31,42,43,47,63,73,[77][78][79][80],…”

A review of pediatric lumbar spine trauma

“…Gaca et al 9 performed a retrospective radiographic review looking at the occurrence and degree of wedging of the VB from T-10 to L-3 based on anterior/ posterior VB height measurements. Although the previously reported ratio of 0.95 was used as the cutoff for concern about compression fracture, 12 their study revealed that patients without spine injury can have an anterior/ posterior ratio of as low as 0.893. 15 All imaging modalities have their advantages and limitations.…”