Vertebral fractures in children during the COVID-19 pandemic

Abstract

Background. The COVID-19 pandemic has had a significant influence on the main epidemiological indicators of emergency trauma, as well as on the pediatric population.
 Aim. This study aimed to analyze the incidence of compression fractures of vertebral bodies in children between January and July 2020 (the first months of COVID-19 pandemic).
 Materials and methods. A comprehensive examination and treatment of 82 children and adolescents aged 317 years, who received compression fractures of the vertebral bodies in the period from January 1 to July 31, 2020, was carried out. A group of 96 children of the same age who sustained a similar type of injury at the same time in 2019 was studied as a control. To make a clinical diagnosis, we used methods of traditional research examination for emergency traumatology. The severity of vertebrogenic fractures was determined according to the AO/ASIF classification.
 Results. The total number of patients diagnosed with vertebral fractures during the COVID-19 pandemic was 14.58% less than that in the same period in 2019. Patients in the comparison groups were comparable in sex, average age of injury, and age group in which the spine was most often injured. The most frequent mechanism of spinal injuries in patients of the comparison groups was a fall from a height. More often than others, ThVI and ThVII vertebral bodies were broken. The severity of vertebral fractures in all cases corresponded to type A, subtypes A1 and A2. For treatment, conservative methods were used in most cases. During the period of strict self-isolation, in April 2020, no children of the main group had vertebral fracture because they were forbidden to leave their apartments unnecessarily. In May 2020, the number of children with vertebral fractures was half the number in the same month in 2019. In June 2020, the incidence of vertebral fractures was in line with the pre-crisis average.
 Conclusion. Strictly following restrictive anti-epidemic measures during a pandemic is an effective method of reducing the number of cases requiring emergency treatment for compression fractures of the vertebral bodies in children.