Abstract
The aim of this study was to present the frequencies and characteristics of paediatric spine fractures, focusing on injury mechanisms, diagnostics, management, and outcomes. This retrospective, epidemiological study evaluated all patients aged 0 to 18 years with spine fractures that were treated at a level 1 trauma centre between January 2002 and December 2019. The study population included 144 patients (mean age 14.5 ± 3.7 years; 40.3% female and 59.7% male), with a total of 269 fractures. Common injury mechanisms included fall from height injuries (45.8%), with an increasing prevalence of sport incidents (29.9%) and a decreasing prevalence of road incidents (20.8%). The most common localisation was the thoracic spine (43.1%), followed by the lumbar spine (38.2%), and the cervical spine (11.8%). Initially, 5.6% of patients had neurological deficits, which remained postoperatively in 4.2% of patients. Most (75.0%) of the patients were treated conservatively, although 25.0% were treated surgically. A small proportion, 3.5%, of patients presented postoperative complications. The present study emphasises the rarity of spinal fractures in children and adolescents and shows that cervical spine fractures are more frequent in older children, occurring with a higher rate in sport incidents. Over the last few years, a decrease in road incidents and an increase in sport incidents in paediatric spine fractures has been observed.
Highlights
Paediatric spine fractures are relatively rare, with an incidence ranging from 1% to 4% [1]
Cervical spine fractures constitute about 1% of all spine fractures in children and adolescents, whereas thoracic and lumbar fractures make up 2–3% [2,3,4,5,6]
The current study shows that paediatric spine fractures are relatively rare with a peak in middle aged children with a mortality rate of 1.4%
Summary
Paediatric spine fractures are relatively rare, with an incidence ranging from 1% to 4% [1]. Cervical spine fractures constitute about 1% of all spine fractures in children and adolescents, whereas thoracic and lumbar fractures make up 2–3% [2,3,4,5,6]. The localisation of spine fractures varies with age: thoracic and lumbar spine fractures occur more often in older children (>10 years), whereas cervical spine fractures occur more frequently in younger children [6,7,8]. The upper cervical spine (C0–C2) is especially at risk of fracturing in children younger than 8–10 years due to the different fulcrum and relatively large head compared to adults [9]. At ages between 8 and 10 years, the anatomy and biomechanics of the paediatric spine are comparable with the adult spine [10]. Explain the scientific background and rationale for the investigation being reported State specific objectives, including any prespecified hypotheses
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