Spinal injuries in the pediatric age group: a review of 82 cases of spinal cord and vertebral column injuries

Abstract

A review of 82 children with spinal cord and/or vertebral column injury treated in our department between 1968 and 1993 showed that 67% of the patients were boys and the average age was 11.4 years. The cause, vertebral level, and type of injury, and the severity of neurological injury varied with the age of the patient. The cause of pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (56%) followed by vehicular accidents (23%). The most frequent level of spinal injury was in the cervical region (57%, 47 patients) followed by the lumbar region (16.5%, 13 patients). In our series, 18% of the patients had complete injury and the overall mortality rate was 3.6%. Eleven children (13%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 39 (47%) had evidence of neurological injury. Although the spinal injury patterns differed between children and adolescents, the outcome was found to be predominantly affected by the type of neurological injury (P < 0.05). Children with complete myelopathy uniformly remained with severe neurological dysfunction; children with incomplete myelopathy recovered nearly normal neurological function. Finally, the authors conclude that most spinal injuries can be successfully managed with nonoperative therapy. The literature is reviewed as to the treatment and outcome of pediatric spinal injuries.

Traumatic spinal injuries in children at a single level 1 pediatric trauma centre: report of a 23-year experience

“…The location of injury in patients with SCIWORA commonly involves the cervical cord, 20,21 but may also occur in the thoracic spine in association with high-energy trauma, 22,23 such as MVCs. Trigylidas and colleagues 20 found that 10% of myelopathic patients presented with associated head injuries and that 50% of these head injuries occurred in patients with SCIWORA.…”

Pediatric care report of spinal cord injury without radiographic abnormality (SCIWORA): case report and literature review

“…The patient, however, was still treated with steroids, which is the treatment for an acute attack of chronic inflammation, for example, multiple sclerosis 15 or for SCIWORA. [3][4][5][6][7][8][9]16 Technically inadequate radiographic series of the cervical spine may miss the diagnosis of a cervical spine injury. Views required include a posterioanterior, lateral and odontoid view.…”

“…Turgut 7 described its incidence in 13% of the 82 children he treated with spinal cord and/or vertebral column injury. Pang, 2 on the other hand, reported its incidence at 66.7%.…”

1998 ARRS Executive Council Award. Radiology in the emergency department: technique for quantitative description of use and results. American Roentgen Ray Society.

“…Because one has access to the referring physician and clinical his toI)@ one could also develop a set ofclinical crite na that is most likely to identify a study with abnormal findings. AlthOUghsuch criteria have been developed for certain clinical presentations [18][19][20][21], suchcriteria haverarely beentestedor validated thmugh imaging studies. Our search method also allows the radiologist interpreting the study to track reports.…”