Paediatric spinal trauma presenting to a UK major trauma centre

Childs Nerv Syst. 2021 Jun;37(6):1949-1956. doi: 10.1007/s00381-021-05044-8. Epub 2021 Jan 29.

Abstract

Purpose: Paediatric spine trauma is uncommon and is managed differently from adults due to the anatomical differences of the paediatric spine. The paediatric spine is less ossified, with lax ligaments and a higher fulcrum in the c-spine which results in a different pattern of injuries. The aim of this study is to provide a contemporary audit of paediatric spinal trauma.

Methods: A retrospective review was conducted using the Trauma and Audit Research Network database at a major trauma centre (2011-2018). All patients < 18 years old with a spine injury underwent case note and radiology review.

Results: A total of 72 patients (37, 51.4% male with an average age of 13.3 (± 5.9) years old) were identified. The most common mechanism of injury was road traffic collisions (n = 39, 54.2%). The most common sporting cause was motocross accidents (n = 6, 8.3%), and a further 6 (8.3%) patients had a suspected inflicted injury. Eight patients (11.1%) sustained a spinal cord injury. Twenty-seven (37.5%) patients underwent surgical intervention to treat their spinal injury.

Conclusion: This series demonstrates the profile of injury mechanisms causing paediatric spinal injuries. Paediatric spine injuries continue to have the potential for lifelong disability and require careful, specialist management. This series also highlights certain causes such as motocross accidents and suspected inflicted injury which are more frequent than expected and raise potential public health concerns.

Keywords: Child abuse; Paediatric spinal injury; SCIWORA; Spinal fracture.

MeSH terms

  • Accidents, Traffic
  • Adolescent
  • Adult
  • Child
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Spinal Cord Injuries* / diagnostic imaging
  • Spinal Cord Injuries* / epidemiology
  • Spinal Cord Injuries* / etiology
  • Spinal Injuries* / epidemiology
  • Spinal Injuries* / etiology
  • Trauma Centers
  • United Kingdom / epidemiology