Pediatric cervical spine injuries with neurological deficits, treatment options, and potential for recovery.

Belal Elnady,Mohamed El-Meshtawi,Ahmed Shawky,Essam El-Morshidy

doi:10.1051/sicotj/2017035

Belal Elnady, Mohamed El-Meshtawi + Show 2 more

Open Access

https://doi.org/10.1051/sicotj/2017035

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Journal: SICOT-J	Publication Date: Jan 1, 2017
Citations: 5	License type: cc-by

Affiliation: Assiut University, Helios Klinikum Erfurt

Abstract

Purpose: The purpose of the present study was to highlight the challenges in managing cervical spine injuries in children with neurological deficits. Introduction: Cervical spine injuries in children are relatively rare. Pattern, severity, and level of these injuries are age dependent. Neurological deficits in young children are uncommon and usually have a good potential for recovery. Patients and methods: This report includes four cases with pediatric cervical spine injuries with variable degrees of spinal cord injuries and neurological deficits. All the four patients were five years old or younger at the time of injury. Those patients were presented with different patterns of injuries and the treatment was customized for every patient. Marked neurological improvement occurred in all patients at the last follow-up. Conclusion: The treatment of pediatric cervical spine injuries should be individualized. Children with stable injuries should do well with non-operative treatment while operative treatment is recommended when the indication is appropriate and the expertise is available. Neurological deficits due to spinal cord injuries in pediatric patients have a high potential for recovery, provided that adequate management is considered.

Highlights

IntroductionCervical spine injuries in children are relatively rare, representing only about 2% of all spine trauma [1]
A five-year-old boy was presented to the outpatient clinic with a history of a motor vehicle accident six months previously which resulted in traumatic C1/2 instability with incomplete quadriplegia
He had an operation in another hospital during which he had a non-instrumented C1/2 fusion using iliac bone graft and absorbable sutures

Summary

Introduction

Cervical spine injuries in children are relatively rare, representing only about 2% of all spine trauma [1]. A five-year-old boy was presented to the outpatient clinic with a history of a motor vehicle accident six months previously which resulted in traumatic C1/2 instability with incomplete quadriplegia. He had an operation in another hospital during which he had a non-instrumented C1/2 fusion using iliac bone graft and absorbable sutures. Neurological examination revealed Frankle C quadriparesis, while radiological evaluation showed persistent C1/2 instability with C2/3 posterior fusion (which may have resulted unintentionally from the previous surgery). This child was planned for revision surgery. At the last follow-up six months after surgery, the neurological status had improved to normal (Frankle D) with solid C2/3 fusion on the plain radiograph (Figure 5)

Discussion

Findings

Conclusion