Manuel Ribeiro da Silva1, Daniela Linhares2,3, Pedro Cacho Rodrigues4, Eurico Lisboa Monteiro5, Manuel Santos Carvalho2, Pedro Negrão2, Rui Peixoto Pinto2, Nuno Neves2. 1. Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal. manuelrisilva@gmail.com. 2. Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal. 3. Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Centro Hospitalar de S. João, EPE, Porto, Portugal. 4. Orthopaedic Department, Hospital da Prelada, Porto, Portugal. 5. Orthopaedic Department, Centro Hospitalar de Entre o Douro e Vouga, EPE, Santa Maria da Feira, Portugal.
Abstract
PURPOSE: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. METHODS: Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. RESULTS: Seventy-five cases of C-spine injuries (nine SCIWORA) were identified. Group A included 23 patients and group B 52. In group A, skeletal injuries at the upper C-spine were more common than injuries at the lower C-spine, whereas in group B, injuries of the lower C-spine were more frequent (p = 0.035). Motor vehicle accidents were the main cause of injury (44 %); 25.3 % of patients were surgically treated. Thirty-nine patients presented neurologic deficits, 16 of which improved. The overall mortality rate was 18.7 % and significantly higher in patients with neurological damages (p < 0.001) CONCLUSIONS: This study revealed a low incidence of cervical spine injuries in the paediatric population. As in previous reports younger children mainly sustained injuries at the upper C-spine, higher incidence of spinal injuries, and higher risk of death than older children.
PURPOSE: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. METHODS: Clinical records of pediatric traumapatients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. RESULTS: Seventy-five cases of C-spine injuries (nine SCIWORA) were identified. Group A included 23 patients and group B 52. In group A, skeletal injuries at the upper C-spine were more common than injuries at the lower C-spine, whereas in group B, injuries of the lower C-spine were more frequent (p = 0.035). Motor vehicle accidents were the main cause of injury (44 %); 25.3 % of patients were surgically treated. Thirty-nine patients presented neurologic deficits, 16 of which improved. The overall mortality rate was 18.7 % and significantly higher in patients with neurological damages (p < 0.001) CONCLUSIONS: This study revealed a low incidence of cervical spine injuries in the paediatric population. As in previous reports younger children mainly sustained injuries at the upper C-spine, higher incidence of spinal injuries, and higher risk of death than older children.
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