Pediatric Spinal Injury Type and Severity Are Age and Mechanism Dependent

Abstract

Retrospective case review. This study aims to characterize a broad spectrum of spinal injuries, from minor soft tissue injuries to spinal cord injuries. We hypothesized that the pattern of pediatric spinal injury would depend on age and cause. While pediatric spinal trauma is generally considered to be rare, the impact of serious spinal trauma is considerable, both in medical and socioeconomic terms. Comparison of serious and minor injuries has rarely been carried out for pediatric spinal injury cases. All children up to age 16 who sustained spinal trauma, as defined by ICD10 codes, at 2 pediatric trauma hospitals in Sydney, Australia were identified (N = 340). Data on injury mechanism (defined as the causative event), type, and spinal level were collected and analyzed using logistic regression. Traffic-related incidents accounted for approximately one third of all spinal trauma and half of serious injuries. The cervical spine was the most frequently injured region, with thoracic and lumbar spine injuries becoming more common with age. The upper cervical spine was more commonly seriously injured in young children, and the lower cervical spine was involved more often in older children. The frequency of minor soft tissue neck injuries increased substantially above the age of 8. Serious spinal injury is more likely to occur in conjunction with multiple trauma. Road traffic incidents were more likely to result in serious spinal injury than falls or sporting incidents. This study has shown that the pattern of spinal injury in children is related to age and also the mechanism of injury. While traffic-related incidents are a leading cause of injury across all age groups, emphasis on fall prevention is needed for younger children. Older children, particularly boys, are sustaining spinal trauma in sporting and recreational activities.