Abstract
Cervical fractures are rare in paediatric population. In younger children, cervical fractures usually occur above the level of C4; whereas in older population, fractures or dislocations more commonly involve the lower cervical spine. Greater elasticity of intervertebral ligaments and also the spinal vertebrae explains why cervical fractures in paediatric ages are rare. The injury usually results from a symmetric or asymmetric axial loading. In paediatric cases, most fractures occur through the synchondroses which are the weakest links of the atlas. The prognosis depends on the severity of the spinal cord injury. In this case, we presented an anterior fracture in synchondrosis of atlas after falling on head treated with cervical collar. There was no neurologic deficit for the following 2 years.
Highlights
Cervical fractures rarely occur in pediatric age group
When a pediatric patient presents with persistent pain and limited movement of the neck and plain radiographs do not demonstrate an abnormality, high resolution computed tomography should be undertaken to assess for minimally displaced fractures through the anterior synchondrosis
We describe a case of a fracture through the anterior synchondrosis and illustrate the contribution of reconstructed CT images to interpretation
Summary
Cervical fractures rarely occur in pediatric age group. Since the first description of an atlas fracture in 1822, there have been few reported cases. When a pediatric patient presents with persistent pain and limited movement of the neck and plain radiographs do not demonstrate an abnormality, high resolution computed tomography should be undertaken to assess for minimally displaced fractures through the anterior synchondrosis. We describe a case of a fracture through the anterior synchondrosis and illustrate the contribution of reconstructed CT images to interpretation. Conventional standard radiographs of the cervical spine did not show evidence of a fracture. The patient had the cervical spine immobilized via a collar and was ordered thiocolchicoside 2 × 2 mg for the symptoms. During her followup, she did not have any neurological deficits
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