Indian Journal of Neurotrauma 2006; 03(01): 41-48
DOI: 10.1016/S0973-0508(06)80009-2
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

A Study on Pediatric Spinal Injury : An IPGMER, Kolkata Experience

A Dhal
,
K Roy
,
S Ghosh
,
R Kanjilal
,
P Tripathy
,
SP Ghorai
,
BC Mohanty

Subject Editor:
Further Information

Publication History

Publication Date:
05 April 2017 (online)

Abstract

Pediatric spinal trauma is devastating and life-threatening. The medical, emotional and economic impact can be immense throughout the lifespan of the injured child, if not treated in time. Seventy five percent of the injury occurs in the cervical region between the age of infancy and eight years, but the incidence decreases with increasing age. Beyond 14 years, the incidence follows the adult pattern. Management depends upon the age, severity, level of injury and degree of neurological deficits. Surgical techniques like fusion and instrumentation can be successfully used in children also. Our study aims to analyze the incidence, mechanism of injury, risk factor, treatment and outcome of pediatric spinal injuries treated at our institute from September 2000 to August 2004. Total number of patients was 50 (M=32, F=18), and were divided into two age groups (0–8 years, 9–14 years). All patients were assessed clinically and radiologically. Surgical treatment was offered in 14 patients. All patients were followed up for a period ranging from 6 months to three years. Pediatric spinal injuries are no longer rare, and different types of fusion and instrumentation procedures can be performed with a good outcome.

 
  • References

  • 1 Anderson MJ, Schutt AH. Spinal injury in children; A review of 156 cases seen from 1950 through 1978. Mayo Clin Proc 55 1980; 499-504
  • 2 Andrew SLG, Jung SK. Spinal cord injuries in children in British Columbia. Paraplegia 17 1979; 442-451
  • 3 Burke DC. Spinal cord trauma in children. Paraplegia 09 1971; 1-14
  • 4 Geisler FH, Dorsey FC, Coleyman WP. Recovery of motor function after spinal cord injury- a randomized, placebo controlled trial with GM-1 ganglioside. N Engl J Med 324 1991; 1829-1838
  • 5 Hadley MN, Sonntag VKH, Rekate HL. Pediatric Vertebral Column and spinal cord injuies. Contemp Neurosurg 10 1988; 1-6
  • 6 Henrys P, Lye ED, Lifton C, Salci ccioli G. Clinical review of cervical spine injuries in children. Clin Orthop 129 1977; 172-176
  • 7 Kewalramani LS, Tori JA. Spinal cord trauma in children: Neurologic patterns, radiologic features and pathomechanics of injury. Spine 05 1980; 11-18
  • 8 Kewalramani LS, Kraus JF, Sterling HM. Acute spinal cord lesions in a pediatric population: Epidemiological and clinical features. Paraplegia 18 1980; 206-219
  • 9 Meljack J. Paraplegia among children. Lancet 02 1969; 45-48
  • 10 Mendelsohn DB, Zollars L, Weatherall PT. et al MR of cord transection. J Comput Assist Tomogr 14 1990; 909-911
  • 11 Ruge JR, Sinson GP, McLone DG. et al Pediatric spinal injury: The very young. J Neurosurg 68 1988; 25-30
  • 12 Schaeffer DM, Flanders AE, Osterholm JL, Northrup BE. Prognostic significance of magnetic resonance imaging in the acute phase of cervical spine injury. J Neurosurg 76 1992; 218-223
  • 13 Wilberger Jr JE. et al Spinal cord injuries in children. 1986. Futura publishing; Mount Kisco NY: 7-11
  • 14 Hadley MN, Zabramski JM, Browner CM. et al Pediatric spinal trauma: Review of 122 cases of spinal cord and vertebral column injuries. J Neurosurg 68 1988; 18-24
  • 15 Hamilton MG, Myles ST. Pediatric spinal injury: Review of 174 hospital admissions. J Neurosurg 77 1992; 700-704
  • 16 Hamilton MG, Myles ST. Pediatric spinal injury: Review of 61 deaths. J Neurosurg 77 1992; 705-708
  • 17 Hill SA, Miller CA, Kosnik EJ, Hunt WE. Pediatric neck injuries: A clinical study. J Neurosurg 60 1984; 700-706
  • 18 Osenbach RK, Menezes AH. Spinal cord injury without radiographic abnormality in children. Pediatric Neurosci 15 1989; 168-175
  • 19 Pang D. Spinal cord injury without radiographic abnormality Spinal cord injury without radiographic abnormality (SCIWORA) in children. In Betz R. (ed): The child with a spinal cord injury. 1996. AAOS and Shriners Hospital; Rosemont, IL: 139-160
  • 20 Pang D, Pollock IF. Spinal cord injury without radiographic abnormality in children: The SCIWORA syndrome. J Trauma 29 1989; 654-664
  • 21 Hall E, Boyd Sten JW. Pediatric Neck injuries. Pediatrics Review 20 1999; 13-19
  • 22 Zambramski JM, Hadley MN, Browner CM. et al Pediatric spinal cord and vertebral column injuries. Barrow Neurol Inst J 02 1986; 11-17
  • 23 Beatson TR. Fractures and dislocations of the cervical spine. J Bone Joint Surg Br 45 1963; 21-35
  • 24 Hubbard DD. Injuries of the spine in children and adolescents. Clin Orthop 100 1974; 56-65
  • 25 American College of Surgeons. Advanced Trauma Life Support. 5th . ed, 1995. American College of Surgeons; Chicago:
  • 26 Apple JS, Kirks DR, Marten DF. Cervical spine fractures and dislocations in children. Pediatr Radiol 17 1987; 45-49
  • 27 Dickman CA, Zabramski JM, Hadley MN. pediatric spinal cord injury without radiographic abnormalities: Report of 26 cases and review of the literature. J Spinal Disord 04 1991; 296-305
  • 28 Farley FA, Hensinger RN, Herzenberg JE. Cervical spinal cord injury in children. J Spinal Disord 05 1992; 410-416
  • 29 Pang D, Wilberger Jr. JE. Spinal cord injury without radiographic abnormalities in children. J Neurosurg 57 1982; 114-129
  • 30 Fesmire FM, Luten RC. The pediatric cervical spine: developmental anatomy and clinical aspects. J Emerg Med 07 1989; 133-142
  • 31 Manamy MJ, Jaffe DM. Cervical spine injuries in children. Pediatr Ann 25 1996; 423-428
  • 32 Hill SA, Miller CA, Kosnik EJ. Pediatric neck injuries. A clinical study. J Neurosurg 60 1984; 700-706
  • 33 Niteckis CR. Moir. Predictive factors of the outcome of traumatic cervical spine fracture in children. J Pediatr Surg 29 1994; 1409-1411
  • 34 Osenbach RK, Menezes AH. Pediatric spinal cord and vertebral column injury. Neurosurgery 30 1992; 385-390
  • 35 Rockswald GL, Seljeskog EL. Traumatic atlantocranial dislocation with survival. Minn Med 62 1979; 151-154
  • 36 Orenstein JB, Klein BL, Got Schalf CS. Age and outcome in pediatric cervical spine injury:11year experience. Pediatric Emergency Care 10 1994; 132-137
  • 37 Givens TG, Polley KA, Smith GF. Pediatric cervical spine injury: a thre year experience. J Trauma 41 1996; 310-314
  • 38 Birney TJ, Hanley Jr. EN. Traumatic cervical spine injuries in childhood and adolescence. Spine 14 1989; 1277-1282
  • 39 Henrys P, Lyne ED, Lifton C. Clinical review of cervical spine injuries in children. Clin Orthop 129 1977; 172-176
  • 40 Michael DB, Guyot DR, Darmody WR. Coincidence of head and cervical spine injury. Neurotrauma 06 1989; 177-189
  • 41 Mirvis SE, Diaconis JN, Chirico PA. Protocol driven radiologic evaluation of suspected cervical spine injury: efficacy study. Radiology 170 1989; 831-834
  • 42 Rauzzino MJ, Hadley MN. Pediatric spinal cord injuries. In Menezes AH, Sonntag VKH. (eds): Principles of spinal surgery. 1996. McGraw-Hill; New York: 817-840
  • 43 Grabb PA, Pang D. Magnetic resonance imaging in the evaluation of spinal cord injury without radiographic abnormality in children. Neurosurgery 35 1994; 406-414
  • 44 Webb JK, Broughton RBK, MCS Weeney T. et al Hidden flexion injury of the cervical spine. J Bone Joint Surg Br 58 1976; 322-327
  • 45 Frankel HL, Hancock DO, Hyslop G. et al The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 07 1969; 179-192
  • 46 Burke DC. Traumatic spinal paralysis in children. Paraplegia 11 1974; 268-276
  • 47 Cheoi JU, Hoffman HJ, Hendrick EB. et al Traumatic infarction of the spinal cord in children. J Neurosurg 65 1986; 608-610
  • 48 Hachen HJ. Spinal cord injury in children and adolescents: Diagnostic pitfalls and therapeutic considerations in the adult stage. Paraplegia 16 1977; 55-64
  • 49 Hasue M, Hoshino R. Omatas. et al Cervical spine injuries in children. Fukushima J Med Sci 20 1974; 115-123
  • 50 Yngve DA, Harris WP, Herndon WA. et al Spinal cord injury without spine fracture. J Pediatr Orthop 08 1988; 153-159
  • 51 Fesmire FM, Luten RC. The Pediatric Cervical Spine: Developmental anatomy and clinical aspects. J Emerg Med 07 1989; 133-142
  • 52 Sherk HH, Schut L, Lane JM. Fractures and dislocations of the cervical spine in children. Orthop Clin North Am 07 1976; 593-604
  • 53 Fielding JW. Injuries of the cervical spine in children. In Rockwood Jr CA, Wilkins KE, King RE. (eds): Fractures in children. 3 1984. JB Lippincott; Philadelphia: 683-705
  • 54 Kaufman RA, Caroll CD, Buncher CR. Atlanto -occipital junction: Standards for management in normal children. AJNR 08 1987; 995-999
  • 55 Ruge JR, Sinson GP, Mclone DG. Pediatric spinal injury: The very young. J Neurosurg 68 1988; 25-30
  • 56 Salch J, Raycrroft JF. Hyperflexion injury of cervical spine and central cord syndrome in a child. Spine 17 1992; 234-237
  • 57 Roy L, Gibson DA. Cervical spine fusion in children. Clin Orthop 73 1970; 146-151
  • 58 Shacked L, Ram J, Hadani M. The anterior cervical approach for traumatic injuries to the cervical spine in children. Clin Orthop 292 1993; 144-150
  • 59 Lowry DW, Pollack IF, Chyde B. Upper cervical spine fusion in the pediatric population. J Neurosurg 87 1997; 671-776