The diagnosis and treatment of cervical spine injuries in children

Abstract

Objective To review our experience in diagnosis and treatment of pediatric cervical spine injuries. Methods From January 1995 to December 2005, 11 patients including 8 boys and 3 girls were recruited in this study. Their mean age was 12. 14 years, ranged from 5 to 17 years. The causes for injury included falls (3 cases), sports related injuries (3 cases), traffic accidents (2 cases), direct hit injuries (2 bcases), and entertainment related injuries (1 case). All patients underwent neurological and radiological examinations. The treatments were carried out according to the results of such examinations. Results The injury sites were C1-3 in 4 patients and C4-7 in 7 patients. Neurological function was evaluated according to Frankel score: 1 case of Frankel A, 1 case of Frankel B, 2 cases of Frankel C and 7 cases of Frankel E. One of the 11 patients was affected by spinal cord injury without radiographic abnormality. Seven patients were cured by conservative treatments. The other 4 patients underwent operations, 2 were anterior decompression and fusion operations and the other 2 were posterior approach operations. Among the 2 cases with posterior approach, 1 was decompression operation, and the other one was decompression and fusion operation. Five patients had been followed up for up to 5. 6 years. All patients were cured without complications. Conclusions Injuries to the pediatric cervical spine occur infrequently. Numerous unique anatomic and biomechanical features of the pediatric spine render the spine much more flexible than adult. The treatment strategies in children with cervical spine injuries are based on the age and the mechanism of injury. Key words: Spine injuries; Cervical vertebrae; injuries