Corentin Dauleac1, Pierre-Aurélien Beuriat2, Federico Di Rocco3, Alexandru Szathmari4, Carmine Mottolese4. 1. Department of Neurosurgery, Hospices Civils de Lyon, Hospital for Neurology and Neurosurgery Pierre Wertheimer, Lyon, France; Université de Lyon, Université Claude Bernard, Lyon, France. Electronic address: corentin.dauleac@chu-lyon.fr. 2. Department of Neurosurgery, Hospices Civils de Lyon, Hospital for Neurology and Neurosurgery Pierre Wertheimer, Lyon, France; Université de Lyon, Université Claude Bernard, Lyon, France; Department of Pediatric Neurosurgery, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France. 3. Université de Lyon, Université Claude Bernard, Lyon, France; Department of Pediatric Neurosurgery, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France. 4. Department of Neurosurgery, Hospices Civils de Lyon, Hospital for Neurology and Neurosurgery Pierre Wertheimer, Lyon, France; Department of Pediatric Neurosurgery, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France.
Abstract
OBJECTIVE: Spine trauma management in children varies from one team to another, and to date, no clear consensus has been reached. The goal of this study was to describe the epidemiology of spine trauma in children and evaluate the timing and techniques of surgery when it was required. METHODS: A retrospective review of all patients admitted to our pediatric trauma center for spine traumas that required surgical management, between 2005 and 2016, was performed. All patients were followed with clinical and radiologic examination to evaluate the quality of fusion and realignment. RESULTS: Seventy-three children, with a mean age of 14.1 years, were admitted. Spinal injuries were more common in the teenage group (14-18 years). The predominant etiology of spine injuries was motor vehicle collision (36%). The spinal level of injury varied according to the age group: young children presented more cervical traumas (P < 0.01), while teenagers presented more lumbar traumas. There were more fractures alone in the teenage group (P < 0.005), while there were more luxations alone in the school-age group (P < 0.05). Median timing for surgical intervention in patients with neurologic deficits was 1 day. Patients with posterior wall recession >5 mm underwent surgical management quicker than patients with no posterior wall recession (P < 0.03). At follow-up, out of the 37 patients with initial neurologic deficits, 14 had improved (38%). CONCLUSIONS: Diskoligament maturation is an essential concept in spine traumas in children, as well as in surgical management. Surgical procedures should be carried out as soon as possible when patients present with neurologic deficits. At the thoracolumbar junction, a 2-level up-and-down fixation is recommended.
OBJECTIVE: Spine trauma management in children varies from one team to another, and to date, no clear consensus has been reached. The goal of this study was to describe the epidemiology of spine trauma in children and evaluate the timing and techniques of surgery when it was required. METHODS: A retrospective review of all patients admitted to our pediatric trauma center for spine traumas that required surgical management, between 2005 and 2016, was performed. All patients were followed with clinical and radiologic examination to evaluate the quality of fusion and realignment. RESULTS: Seventy-three children, with a mean age of 14.1 years, were admitted. Spinal injuries were more common in the teenage group (14-18 years). The predominant etiology of spine injuries was motor vehicle collision (36%). The spinal level of injury varied according to the age group: young children presented more cervical traumas (P < 0.01), while teenagers presented more lumbar traumas. There were more fractures alone in the teenage group (P < 0.005), while there were more luxations alone in the school-age group (P < 0.05). Median timing for surgical intervention in patients with neurologic deficits was 1 day. Patients with posterior wall recession >5 mm underwent surgical management quicker than patients with no posterior wall recession (P < 0.03). At follow-up, out of the 37 patients with initial neurologic deficits, 14 had improved (38%). CONCLUSIONS: Diskoligament maturation is an essential concept in spine traumas in children, as well as in surgical management. Surgical procedures should be carried out as soon as possible when patients present with neurologic deficits. At the thoracolumbar junction, a 2-level up-and-down fixation is recommended.
Authors: James Booker; Samuel Hall; Alexander Dando; Christopher Dare; Evan Davies; Stephen McGillion; Nijaguna Mathad; Ryan Waters; Vassilios Tsitouras; Nilesh Mundil; Salima Wahab; Aabir Chakraborty Journal: Childs Nerv Syst Date: 2021-01-29 Impact factor: 1.475
Authors: Stephan Payr; Andrea Schuller; Theresia Dangl; Britta Chocholka; Harald Binder; Thomas M Tiefenboeck Journal: Children (Basel) Date: 2021-12-03