Posttraumatic vertebral disc alterations after B and C type spinal injuries in childhood-Clinical and radiological 10-year results for two cases

Abstract

Pediatric traumatic vertebral injuries usually present as stable A (AOspine classification) fractures, whereas B and C injuries are relatively uncommon. In contrast to adults the appropriate treatment strategy in children remains an issue of debate.The data from two pediatric patients admitted with B and C type spinal injuries in 2007 and 2008 were retrospectively analyzed. The initial diagnostics were performed via computed tomography (CT) and an additional magnetic resonance imaging (MRI) was carried out in one case.The clinical and radiological follow-up controls were carried out after 77 and 66 months as well as 123 and 112 months, respectively. In both cases thoracolumbar MRI scans revealed degenerative alterations of the ventral half of the L1/L2 disc with aregular disc signal in the dorsal segment at the first follow-up and aprogressive disc degeneration in one patient at the second follow-up.Surgical treatment of pediatric B and C type injuries via open reduction and temporary monosegmental posterior screw and rod instrumentation results in satisfactory clinical and radiological outcomes. In the absence of vertebral burst fractures, the function and stability of discoligamentous injuries in children can be restored without any additional osseous fusion.