2 Biomechanics of the Pediatric Spine

Kim, Daniel H.; Betz, Randal R.; Huhn, Stephen L.; Newton, Peter O.

doi:10.1055/b-0034-72563

Cited by 1 publication

(2 citation statements)

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“…Pediatric spines are significantly different when compared to their adult counterparts (4,16). Children have significant resilience to trauma due to the amount of cartilaginous tissue present within the spinal column, increased water content of the intervertebral disks, and increased laxity and elasticity (2,3,(17)(18)(19)(20)(21)(22).…”

Section: Biomechanics Of the Lumbar Spinementioning

confidence: 99%

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Abusive Pediatric Thoracolumbar Fracture Due to Forced Hyperextension: Case Report, Biomechanical Considerations, and Review of the Literature

Webb¹,

Sherman

Sung³

et al. 2020

Journal of Forensic Sciences

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Pediatric thoracolumbar fractures are rare due to the physiological differences which afford greater resilience to the immature spine. Most pediatric thoracolumbar fractures occur as the result of high energy trauma, such as motor vehicle accidents, and modes of reasonable accidental injuries are limited by age and developmental capabilities of the child. These fractures can occur as the result of inflicted blunt force trauma and child abuse, and in most cases, the mechanism of injury to the spine is not known. We report the death of a 29-month-old man due to blunt force trauma to the back and forced hyperextension of the thoracolumbar spine causing fracture of the fourth lumbar (L4) vertebral body. A complete forensic examination revealed a previous healing fracture of the anterior aspect of the L4 vertebral body, with acute disruption of the anterior longitudinal ligament overlying the fracture site, complete fracture of the vertebral body, and fatal retroperitoneal hemorrhage. We present a review of the biomechanical considerations of the pediatric spine, a survey of pediatric spinal fractures, and a review of the literature on pediatric abusive thoracolumbar fractures. In this case, there was never a provided explanation for how the injury occurred; however, understanding the biomechanics of the pediatric spine allowed for the determination of the mechanism, force required to produce this specific pattern of abusive spinal injury, and the manner of death.

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Section: Biomechanics Of the Lumbar Spinementioning

confidence: 99%

“…The spine in young children has increased elasticity of the ligaments, increased water content in the intervertebral disks, and greater capacity for growth and remodeling than the spine of an older child, adolescent, or adult. The spines in young children can thus withstand and dissipate greater forces (4)(5)(6).…”

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confidence: 99%