Pediatric cervical spine injuries-results of the German multicenter CHILDSPINE study.

Male Female Child Humans Aged Adolescent Child, Preschool Spinal Injuries / epidemiology Cervical Vertebrae / diagnostic imaging Neck Injuries Retrospective Studies Accidents, Traffic

Adolescence Cervical spine trauma Children Pediatric spine trauma

Journal

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

ISSN: 1432-0932

Titre abrégé: Eur Spine J

Pays: Germany

ID NLM: 9301980

Informations de publication

Date de publication:
04 2023

Historique:

received: 31 05 2022

accepted: 08 01 2023

revised: 23 12 2022

medline: 11 4 2023

pubmed: 10 2 2023

entrez: 9 2 2023

Statut: ppublish

Résumé

The aim of this study was to provide epidemiological data of pediatric patients suffering from cervical spinal trauma in Germany, in order to integrate these data in future decision-making processes concerning diagnosis and therapy. Retrospective multicenter study includes all patients up to 16 years suffering from cervical spine injuries who were treated in six German spine centers between 01/2010 and 12/2016. The clinical databases were screened for specific trauma mechanism, level of injury as well as accompanying injuries. Diagnostic imaging and the chosen therapy were analyzed. Patients were divided into three age groups for further evaluation: age group I (0-6 years), age group II (7-9 years), age group III (10-16 years). A total of 214 children with 265 cervical spine injuries were included during the mentioned period. The mean age at the time of injury was 11.9 (± 3.9) years. In age group I, 24 (11.2%) patients were included, age group II consisted of 22 patients (10.3%), and 168 patients belonged to age group III (78.5%). Girls and boys were equally affected. In all age groups, falls and traffic accidents were the most common causes of cervical spine injuries. A total of 180 patients (84.1%) were treated conservatively, while 34 (15.9%) children underwent surgery. Distorsion/whiplash injury was the most common entity (n = 165; 68.2%). Children aged 0-9 years had significantly (p < 0.001) more frequent injuries of the upper cervical spine (C0-C2) compared to older age groups. Patients of age group III were more likely to suffer from injuries in subaxial localizations. Neurological deficits were rarely seen in all age groups. Head injuries did represent the most common accompanying injuries (39.8%, n = 92). The upper cervical spine was more frequently affected in young children. Older children more often suffered from subaxial pathologies. The majority of cervical spinal column injuries were treated conservatively. Nevertheless, 15% of the hospitalized children had to be treated surgically.

Identifiants

DOI: 10.1007/s00586-023-07532-8 PMID: 36757616

pubmed: 36757616

doi: 10.1007/s00586-023-07532-8

pii: 10.1007/s00586-023-07532-8

doi:

Types de publication

Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

1291-1299

Informations de copyright

Références

Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg Am 56:1663–1674

doi: 10.2106/00004623-197456080-00017 pubmed: 4434035

Baerg J, Thirumoorthi A, Hazboun R et al (2017) Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma. J Surg Res 219:366–373

doi: 10.1016/j.jss.2017.06.053 pubmed: 29078907

Baumann F, Ernstberger T, Neumann C, Nerlich M, Schroeder GD, Vaccaro AR et al (2015) Pediatric cervical spine injuries: a rare but challenging entity. J Spinal Disord Tech 28(7):377–384

doi: 10.1097/BSD.0000000000000307

Carreon LY, Glassman SD, Campbell MJ (2004) Pediatric spine fractures: a review of 137 hospital admissions. J Spinal Disord Tech 17:477–482

doi: 10.1097/01.bsd.0000132290.50455.99 pubmed: 15570118

Chaudhry AS, Prince J, Sorrentino C, Fasanya C, McGinn J, Atanassov KD, Bloom S, Price M (2016) Identification of risk factors for cervical Spine injury from pediatric trauma registry. Pediatr Neurosurg 51(4):167–174. https://doi.org/10.1159/000444192 . (Epub 2016 Mar 19 PMID: 26992002)

doi: 10.1159/000444192 pubmed: 26992002

De Caffiniere JY, Seringe R, Roy-Camille R, Saillant G (1972) Physio-pathological study of severe ligament lesions in injuries of the spino-occipital joint. Rev Chir Orthop Reparatrice Appar Mot 58:11–19

pubmed: 4263540

Dietrich AM, Ginn-Pease ME, Bartkowski HM et al (1991) Pediatric cervical spine fractures: predominantly subtle presentation. J Pediatric Surg 26:995–999

doi: 10.1016/0022-3468(91)90850-S

Dogan S, Safavi-Abbasi S, Theodore N et al (2007) Thoracolumbar and sacral spinal injuries in children and adolescents: a review of 89 cases. J Neurosurg 106:426–433

pubmed: 17566397

Fielding JW, Hawkins RJ (1977) Atlanto-axial rotatory fixation. Fixed rotatory subluxation of the atlanto-axial joint. J Bone Joint Surg Am 59:37–44

doi: 10.2106/00004623-197759010-00005 pubmed: 833172

Gehweiler JA, Osborne RL, Becker RF (1980) The radiology of vertebral trauma. W.B. Saunders Company, Philadelphia

Hasler RM, Exadaktylos AK, Bouamra O, Benneker LM, Clancy M, Sieber R, Zimmermann H, Lecky F (2011) Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study. Eur Spine J 20:2174–2180

doi: 10.1007/s00586-011-1866-7 pubmed: 21644051 pmcid: 3229733

Knox JB, Schneider JE, Cage JM et al (2014) Spine trauma in very young children: a retrospective study of 206 patients presenting to a level 1 pediatric trauma center. J Pediatr Orthop 34:698–702

doi: 10.1097/BPO.0000000000000167 pubmed: 25207594

Leonard JR, Jaffe DM, Kuppermann N, Olsen CS, Leonard JC (2014) Pediatric emergency care applied research network (PECARN) cervical spine study group. Pediatrics 133(5):e1179–e1188. https://doi.org/10.1542/peds.2013-3505 . (Cervicalspineinjurypatternsinchildren PMID: 24777222)

doi: 10.1542/peds.2013-3505 pubmed: 24777222

Meinig H, Matschke S, Ruf M, Pitzen T, Disch A, Jarvers JS, Herren C, Weiß T, Jung MK, Rüther H, Welk T, Badke A, Gonschorek O, Heyde CE, Kandziora F, Knop C, Kobbe P, Scholz M, Siekmann H, Spiegl U, Strohm P, Strüwind C, Kreinest M (2020) Diagnostics and treatment of cervical spine trauma in pediatric patients: recommendations from the Pediatric Spinal Trauma Group. Unfallchirurg 123:252–268

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

Parent S, Mac-Thiong JM, Roy-Beaudry M, Sosa JF, Labelle H (2011) Spinal cord injury in the pediatric population: a systematic review of the literature. J Neurotrauma 28(8):1515–1524. https://doi.org/10.1089/neu.2009.1153 . (Epub 2011 Jun 9. Review. PMID: 21501096)

doi: 10.1089/neu.2009.1153 pubmed: 21501096 pmcid: 3143390

Patel JC, Tepas JJ 3rd, Mollitt DL et al (2001) Pediatric cervical spine injuries: defining the disease. J Pediatr Surg 36:373–376

doi: 10.1053/jpsu.2001.20720 pubmed: 11172438

Platzer P, Jaindl M, Thalhammer G et al (2007) Cervical spine injuries in pediatric patients. J Trauma 62:389–396

pubmed: 17297330

Pieretti-Vanmarcke R, Velmahos GC, Nance ML et al (2009) Clinical clearance of the cervical spine in blunt trauma patients younger than 3 years: a multicenter study of the American Association for the Surgery of Trauma. J Trauma 67:543–549

pubmed: 19741398

Ribeiro Da Silva M, Linhares D, Cacho Rodrigues P et al (2016) Paediatric cervical spine injures. nineteen years experience of a single centre. Int Orthop 40:1111–1116

doi: 10.1007/s00264-016-3158-7 pubmed: 27052667

Ruffing T, Wiehmann M, Winkler H et al (2016) Xray of the thoracic and lumbar spine in injured children and adolescents : incidence, fracture rates and therapeutic consequences. Unfallchirurg 121:30

doi: 10.1007/s00113-016-0271-4

Schoneberg C, Schweiger B, Hussmann B et al (2013) Diagnosis of cervical spine injuries in children: a systematic review. Eur J Trauma Emerg Surg 39:653–665

doi: 10.1007/s00068-013-0295-1 pubmed: 26815551

Vaccaro AR, Koerner JD, Radcliff KE, Oner FC, Reinhold M, Schnake KJ, Kandziora F, Fehlings MG, Dvorak MF, Aarabi B, Rajasekaran S, Schroeder GD, Kepler CK, Vialle LR (2016) AOSpine subaxial cervical spine injury classification system. Eur Spine J 25(7):2173–2184. https://doi.org/10.1007/s00586-015-3831-3 . (Epub 2015 Feb 26 PMID: 25716661)

doi: 10.1007/s00586-015-3831-3 pubmed: 25716661

Yang NP, Deng CY, Lee YH et al (2008) The incidence and characterisation of hospitalised acute spinal trauma in Taiwan–a population-based study. Injury 39:443–450

doi: 10.1016/j.injury.2007.12.007 pubmed: 18321510