Paediatric cervical spine injures. Nineteen years experience of a single centre

Silva, Manuel Ribeiro da; Linhares, Daniela; Rodrigues, Pedro; Monteiro, E.; Carvalho, Mário de; Negrão, Pedro; Pinto, Rui; Nevès, Nuno

doi:10.1007/s00264-016-3158-7

Cited by 20 publications

(7 citation statements)

References 32 publications

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“…Основной причиной травм были дорожно-транспортные происшествия. Дети младшего возраста в основном получали травмы в краниальных сегментах шейного отдела позвоночника и имели более высокий риск смерти, чем дети старшего возраста [18]. K.R.…”

Section: Abstract: Sciwora Children Spinal Cord Injury Diagnosis Mri ...unclassified

Sciwora Damage in Children. The Current State of the Issue

Kokushin¹,

Khusainov²

2022

IJAFR (МЖПФИ)

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Вопросы лечения спинальной травмы у пациентов детского возраста являются одной из актуальных проблем современной вертебрологии. На первом месте среди причин травматической патологии позвоночника у детей по данным литературы стоят дорожно-транспортные происшествия и падение с высоты. Возрастные морфофункциональные особенности растущего позвоночника обуславливают особенности и характер его повреждений. В то же время в литературе описаны повреждения шейного отдела позвоночника у детей без отклонений по данным лучевых исследований (спондилографии и компьютерной томографии), представленные как синдром SCIWORA. Механизмы повреждения при этом синдроме включают сгибание, гиперэкстензию, продольную дистракцию и ишемию. В связи с вышеизложенным целью нашего обзора явилось описание современного состояния вопросов особенностей в диагностике и лечении детей с SCIWORA. На основании проведенного анализа литературы, посвященной вопросам диагностики и лечения детей с SCIWORA, наиболее частыми причинами данного вида повреждений у детей являются спортивная травма, дорожно-транспортные происшествия, травмы, полученные при падении. Повреждение SCIWORA у детей младше 1 года является казуистичным. Наиболее выраженный неврологический дефицит отмечен у детей младше 8 лет. Отмечена высокая диагностическая ценность МРТ позвоночника для детей с SCIWORA, позволяющая классифицировать данный вид повреждений по тяжести и прогнозу. При диагностированном SCIWORA пациентам рекомендовано консервативное лечение с помощью иммобилизации жестким воротником и физиотерапии. Рекомендовано применение кортикостероидов. В связи с небольшой частотой встречаемости SCIWORA, тяжелым неврологическим дефицитом, отсутствием разработанных стандартов в диагностике и лечении детей данной категории, необходимо заключение эксперта для руководства наилучшей практикой ведения и обеспечения наилучших шансов на хороший исход для пострадавшего ребенка. Ключевые слова: SCIWORA, дети, травма спинного мозга, диагностика, МРТ, лечение SCIWORA DAMAGE IN CHILDREN. THE CURRENT STATE OF THE ISSUE Kokushin D.N., Khusainov N.O.

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Section: Abstract: Sciwora Children Spinal Cord Injury Diagnosis Mri ...unclassified

Sciwora Damage in Children. The Current State of the Issue

Kokushin¹,

Khusainov²

2022

IJAFR (МЖПФИ)

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“…25,26 These anatomical features, combined with a disproportionate head-torso ratio, result in increased susceptibility to injury of the cervical spine in general and the upper cervical spine in particular in children younger than 8 years. 25,26,35,74,81 By 14 years of age, the spine closely resembles that of the adult spine, whereas children from 9 to 13 years of age represent an intermediate group in terms of spinal development. 26,81 There is no existing prehospital immobilization protocol for trauma patients younger than 13 years.…”

Section: Development Of the Ems Immo Protocol Pediatricmentioning

confidence: 99%

Development of a New Emergency Medicine Spinal Immobilization Protocol for Pediatric Trauma Patients and First Applicability Test on Emergency Medicine Personnel

Nolte

Liao

Kuch³

et al. 2020

Pediatr Emer Care

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Objectives:The purpose of this study was to (i) develop a protocol that supports decision making for prehospital spinal immobilization in pediatric trauma patients based on evidence from current scientific literature and (ii) perform an applicability test on emergency medicine personnel.Methods: A structured search of the literature published between 1980 and 2019 was performed in MEDLINE using PubMed. Based on this literature search, a new Emergency Medicine Spinal Immobilization Protocol for pediatric trauma patients (E.M.S. IMMO Protocol Pediatric) was developed. Parameters found in the literature, such as trauma mechanism and clinical findings that accounted for a high probability of spinal injury, were included in the protocol. An applicability test was administered to German emergency medicine personnel using a questionnaire with case examples to assess correct decision making according to the protocol.Results: The E.M.S. IMMO Protocol Pediatric was developed based on evidence from published literature. In the applicability test involving 44 emergency medicine providers revealed that 82.9% of participants chose the correct type of immobilization based on the protocol. A total of 97.8% evaluated the E.M.S. IMMO Protocol Pediatric as helpful.Conclusions: Based on the current literature, the E.M.S. IMMO Protocol Pediatric was developed in accordance with established procedures used in trauma care. The decision regarding immobilization is made on based on the cardiopulmonary status of the patient, and life-threatening injuries are treated with priority. If the patient presents in stable condition, the necessity for full immobilization is assessed based upon the mechanisms of injury, assessment of impairment, and clinical examination.

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“…Infantile pediatric patients, particularly those under 36 months, have been shown to be a distinct population, with studies showing differences in location of the injury, gender distribution, and treatment recommendations [ 6 , 7 ]. On the other hand, the cervical spine acquires its adult characteristics between the ages of eight to 10 years with these children presenting with injury patterns similar to those seen in adults [ 6 , 8 , 9 ]. Younger pediatric patients are mostly injured in car or motorcycle crashes, whereas older patients suffer significantly more injuries during sports [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Upper Cervical Spine Trauma: A 10-Year Retrospective Review at a Pediatric Trauma Center

Hasan¹,

Waheed²,

Suhrawardy³

et al. 2022

Cureus

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Background Traumatic upper cervical spine injuries (tUCSI) are generally caused by high-impact injuries to the C1-C2 vertebral level. The current literature is limited with regards to comparing epidemiological trends, treatment options, and overall outcomes for tUCSI within the pediatric cohort. The purpose of this study was to analyze pediatric tUCSI epidemiological data, potential variations in treatment and patient outcomes, and to evaluate any specific trends that may be clinically relevant. Methodology We conducted a retrospective cohort study on pediatric patients ages 1 day to 16 years old, admitted for tUCSI over the past 10 years (1/2011 to 1/2021) at a Midwest level 1 trauma center. Retrospective data was queried using ICD-9 and ICD-10 diagnosis codes for tUCSI. Children were stratified into three age groups: Group 1 - Infants and Toddlers (children under three years of age); Group 2 - Young Children (children between three and seven years of age); Group 3 - Juveniles and Adolescents (children between the ages of seven and 16). Numerical data and categorical variables were summarized and the normality of the distribution of data was evaluated using the Anderson-Darling normality test. Differences between the age groups were examined using either an unpaired, independent Two-Sample t-test or Unpaired Mann-Whitney U test. Pearson’s chi-squared or Fisher’s exact tests were used to compare categorical data between groups. Results Forty total patients were included in the final analysis, 23 female (57.5%) and 17 male (42.5%). The mean age was 11 ± 4 (range 2-16). Overall, the most common mechanism of injury was a motor vehicle collision (n=16, 40%), followed by sports injury (n=13, 32.5%), falls (n=6, 15%), and unknown mechanism (n=5, 12.5%). The most common mechanism of injury in young children was a fall (n=4, 57.5%, p <0.001). Adolescents and Juveniles significantly suffer from sports injuries compared to young children (n=13, 39.4%, p =0.043). Mechanisms of injuries presented with unique associated concomitant injuries. The most common associated sites of injuries were lower cervical spine (n=31, 77.5%), and skull injury (n=4, 10%). The vast majority of these cases were managed nonoperatively (pain medication and non-operative cervical orthosis) (n=36, 90%). Mortality and morbidity rates from tUCSI were rare in our cohort (n=1, 2.5%). Conclusion This study found that the majority of pediatric tUCSI patients can be managed nonoperatively, with dislocations and spinal instability being the most common indications for operative management. Commonly used non-operative external fixation methods include cervical collars and Minerva jackets. Our cohort showed very low mortality and morbidity rates, however, these preliminary results will require validation by future prospective multicenter studies.

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Paediatric cervical spine injures. Nineteen years experience of a single centre

Cited by 20 publications

References 32 publications

Sciwora Damage in Children. The Current State of the Issue

Sciwora Damage in Children. The Current State of the Issue

Development of a New Emergency Medicine Spinal Immobilization Protocol for Pediatric Trauma Patients and First Applicability Test on Emergency Medicine Personnel

Pediatric Upper Cervical Spine Trauma: A 10-Year Retrospective Review at a Pediatric Trauma Center

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