Major cervical spine injuries in children and adolescents.

A population-based study of pediatric cervical spine trauma in the Auckland region over 7 years starting in March 1989 identified 32 patients younger than 15 years of age who sustained a fracture, dislocation, or major ligamentous injury including SCIWORA (spinal cord injury without radiographic abnormality). Thirty-one percent had associated injuries and 53% had abnormal neurologic findings on presentation. Children younger than 10 years of age with cervical spine trauma more commonly sustained the injury in a motor vehicle accident and had a preponderance of injuries of the upper cervical spine. Children 10 years of age or older were more often injured during sport or recreational activity and the injuries followed a more typically adult pattern. Treatment included closed reduction in two patients and posterior open reduction and stabilization in eight patients (25%) with one of these also requiring decompression. All patients treated surgically had a very satisfactory outcome.