[Diagnostics and treatment of cervical spine trauma in pediatric patients : Recommendations from the Pediatric Spinal Trauma Group].

Diagnostik und Therapie von Verletzungen der Halswirbelsäule im Kindesalter : Empfehlungen der AG Wirbelsäulentrauma im Kindesalter.

Journal

Der Unfallchirurg
ISSN: 1433-044X
Titre abrégé: Unfallchirurg
Pays: Germany
ID NLM: 8502736

Informations de publication

Date de publication:
Apr 2020
Historique:
entrez: 28 3 2020
pubmed: 28 3 2020
medline: 15 4 2020
Statut: ppublish

Résumé

Severe cervical spine injuries in children under the age of 17 years are rare. Recommendations or even guidelines for the diagnostics and treatment of such injuries in children are currently not available. The aim of the study was to formulate recommendations for diagnostics and treatment of injuries of the cervical spine in pediatric patients. First, a search of primary and secondary literature on the topic complex of diagnostics and treatment of cervical spine injuries in children was carried out. An appropriate internal literature database was defined and maintained. Second, within the framework of 9 meetings from April 2017 to December 2019 the members of the Pediatric Spinal Trauma Group of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) systematically formulated recommendations for the diagnostics and treatment of injuries of the cervical spine in pediatric patients by a consensus process. Recommendation for the diagnostics and treatment for injuries of the cervical spine could be formulated for three age groups (age group I: 0-6 years; age group II: 7-9 years; age group III: 10-16 years). The diagnostic and therapeutic principles known from adult patients suffering from injuries to the cervical spine cannot be easily transferred to pediatric patients. Injuries to the pediatric spine are rare and should be treated in specialized spine centers. Pediatric patients with a stable cardiopulmonary status should undergo magnetic resonance imaging (MRI) if a spinal trauma is suspected. Classification systems and therapeutic recommendations for injuries to the cervical spine known from adult patients could also be used for adolescent patients. This is not possible for children under the age of 10 years. Only few classification systems exist for this age group. Basic principles of the treatment of spinal trauma in children is the restoration of spinal stability and correct anatomical relationships as well as the protection of all neural structures.

Sections du résumé

BACKGROUND BACKGROUND
Severe cervical spine injuries in children under the age of 17 years are rare. Recommendations or even guidelines for the diagnostics and treatment of such injuries in children are currently not available.
OBJECTIVE OBJECTIVE
The aim of the study was to formulate recommendations for diagnostics and treatment of injuries of the cervical spine in pediatric patients.
MATERIAL AND METHODS METHODS
First, a search of primary and secondary literature on the topic complex of diagnostics and treatment of cervical spine injuries in children was carried out. An appropriate internal literature database was defined and maintained. Second, within the framework of 9 meetings from April 2017 to December 2019 the members of the Pediatric Spinal Trauma Group of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) systematically formulated recommendations for the diagnostics and treatment of injuries of the cervical spine in pediatric patients by a consensus process.
RESULTS RESULTS
Recommendation for the diagnostics and treatment for injuries of the cervical spine could be formulated for three age groups (age group I: 0-6 years; age group II: 7-9 years; age group III: 10-16 years). The diagnostic and therapeutic principles known from adult patients suffering from injuries to the cervical spine cannot be easily transferred to pediatric patients.
CONCLUSION CONCLUSIONS
Injuries to the pediatric spine are rare and should be treated in specialized spine centers. Pediatric patients with a stable cardiopulmonary status should undergo magnetic resonance imaging (MRI) if a spinal trauma is suspected. Classification systems and therapeutic recommendations for injuries to the cervical spine known from adult patients could also be used for adolescent patients. This is not possible for children under the age of 10 years. Only few classification systems exist for this age group. Basic principles of the treatment of spinal trauma in children is the restoration of spinal stability and correct anatomical relationships as well as the protection of all neural structures.

Identifiants

pubmed: 32215667
doi: 10.1007/s00113-020-00789-4
pii: 10.1007/s00113-020-00789-4
doi:

Types de publication

Journal Article Practice Guideline Review

Langues

ger

Sous-ensembles de citation

IM

Pagination

252-268

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Auteurs

Holger Meinig (H)

Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Deutschland.

Stefan Matschke (S)

Praxis für Wirbelsäulenchirurgie, ATOS Klinik Heidelberg, Heidelberg, Deutschland.

Michael Ruf (M)

Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Deutschland.

Tobias Pitzen (T)

Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Deutschland.

Alexander Disch (A)

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Dresden, Dresden, Deutschland.

Jan-Sven Jarvers (JS)

Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.

Christian Herren (C)

Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland.

Thomas Weiß (T)

Abteilung Wirbelsäulenchirurgie, BG Unfallklinik Murnau, Murnau, Deutschland.

Matthias K Jung (MK)

Zentrum für Wirbelsäulenchirurgie, BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland.

Hauke Rüther (H)

Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland.

Thomas Welk (T)

Abteilung für Radiologie und Neuroradiologie, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Deutschland.

Andreas Badke (A)

Abteilung für Wirbelsäulenchirurgie, BG Klinik Tübingen, Tübingen, Deutschland.

Oliver Gonschorek (O)

Abteilung Wirbelsäulenchirurgie, BG Unfallklinik Murnau, Murnau, Deutschland.

Christoph E Heyde (CE)

Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.

Frank Kandziora (F)

Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, BG Unfallklinik Frankfurt, Frankfurt, Deutschland.

Christian Knop (C)

Klinik für Unfallchirurgie und Orthopädie, Klinikum Stuttgart, Stuttgart, Deutschland.

Philipp Kobbe (P)

Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland.

Matti Scholz (M)

Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, BG Unfallklinik Frankfurt, Frankfurt, Deutschland.

Holger Siekmann (H)

Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.

Ulrich Spiegl (U)

Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.

Peter Strohm (P)

Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Bamberg, Deutschland.

Christoph Strüwind (C)

Abteilung Wirbelsäulenchirurgie, BG Unfallklinik Murnau, Murnau, Deutschland.

Michael Kreinest (M)

Zentrum für Wirbelsäulenchirurgie, BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland. michael.kreinest@bgu-ludwigshafen.de.

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