Abstract
Cervical spinal injury is a rare condition in children, representing 1.5% of all blunt trauma. The injury pattern differs from that of the adult due to anatomical and biomechanical differences, with the cervical segment being the most prone to injury. Factors that increase the risk of cervical spinal injury are the mechanism of trauma and intrinsic conditions of the patient such as pathologies affecting the joint stability of the spine. The initial approach based on Advanced Trauma Life Support, as well as management focused on the prevention of indirect spinal cord injury, is vital for a better outcome. The use of plain radiographs as a screening method is indicated in patients with suspected spinal injury and the use of other imaging studies depends on the clinical and radiological findings. Spinal injuries in children are associated with a better prognosis with rapid neurological recovery, however they carry significant morbidity and mortality, where complications such as autonomic dysfunction, functional and psychological sequelae and thromboembolic events, are not uncommon.
Keywords
References
Mohseni S, Talving P, Branco BC, Chan LS, Lustenberger T, Inaba K, et al. Effect of age on cervical spine injury in pediatric population: a National Trauma Data Bank review. J Pediatr Surg [Internet]. 2011 [citado 26 enero 2022];46(9):1771-6. Disponible en: https://doi.org/10.1016/j.jpedsurg.2011.03.007
Shin JI, Lee NJ, Cho SK. Pediatric Cervical Spine and Spinal Cord Injury: A National Database Study. Spine (Phila Pa 1976) [Internet]. 2016 [citado 27 enero 2022]; 41:283. Disponible en: 10.1097/BRS.0000000000001176
Leonard JR, Jaffe DM, Kuppermann N, Olsen CS, Leonard JC, Pediatric Emergency Care Applied Research Network (PECARN) Cervical Spine Study Group. Cervical spine injury patterns in children. Pediatrics [Internet]. 2014 [citado 01 febrero 2022];133(5):e1179-88. Disponible en: 10.1542/peds.2013-3505
Parent S, Mac-Thiong J, Roy-Beaudry M, Sosa J, Labelle H. Spinal Cord Injury in the Pediatric Population: A Systematic Review of the Literature. J Neurotrauma [Internet]. 2011 [citado 29 enero 2022];28(8):1515-1524. Disponible en: 10.1089/neu.2009.1153
Salgado Cardozo JP, Suárez Marín MM, Morales JA, Villanueva Ávila M. Particularidades del trauma vertebromedular en niños, revisión de la literatura. Neurocienc J [Internet]. 2018 [citado 06 febrero 2022];25(1):59-6. Disponible en: http://198.12.226.205/index.php/neurocienciasjournal/article/view/24
Habermehl N, Minich NM, Malay S, Mahran A, Kim G. Pediatric Thoracolumbar Spinal Injuries in United States Trauma Centers. Pediatr Emerg Care [Internet]. 2022 [citado el 16 febrero 2022];1;38(2):e876-e880. Disponible en: 10.1097/PEC.0000000000002427
Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery [Internet]. 2004 [citado 10 febrero 2022];55(6):1325–43. Disponible en: 10.1227/01.neu.0000143030.85589.e6
Kaplan CJ. Cervical hyperextension injuries with paraplegia. J Bone Joint Surg Br [Internet]. 1953 [citado 06 febrero 2022];35-B(1):97–100. Disponible en: 10.1302/0301-620X.35B1.97
Leventhal HR. Birth injuries of the spinal cord. J Pediatr [Internet]. 1960 [citado 20 febrero 2022];56(4):447–53. doi: 10.1016/s0022-3476(60)80356-3.
Robles LA. Traumatic Spinal Cord Infarction in a child: Case report and review of literature. Surg Neurol [Internet]. 2007 [citado 06 febrero 2022];67(5):529–34. Disponible en: 10.1016/j.surneu.2006.07.016
Leonard JC, Browne LR, Ahmad FA, Schwartz H, Wallendorf M, Leonard JR, et al. Cervical spine injury risk factors in children with blunt trauma. Pediatrics [Internet]. 2019 [citado 30 enero 2022];144(1). Disponible en: 10.1542/peds.2018-3221
Ma N, Mills S, McBride C, Kimble R, Redmond M. Neurological injuries from skateboards in paediatric and adolescent populations: injury types and severity. ANZ J Surg [Internet]. 2018 [citado 22 febrero 2022];88(4):337-340. Disponible en: 10.1111/ans.14288
Abhinav K, Edwards R, Whone A. Spinal injuries and spinal cord syndromes. En: Abhinav K, Edwards R, Whone A, editores. Rapid Neurology and Neurosurgery. Reino Unido: Wiley – Blackwell; 2018. p.144–150
Brown P, Munigangaiah S, Davidson N, Bruce C, Trivedi J. A review of paediatric cervical spinal trauma. Surgery (Oxford) [Internet]. 2020 [citado 30 enero 2022];38(9):495-499. Disponible en: 10.1016/j.mpsur.2020.06.016
Baerg J, Thirumoorthi A, Hazboun R, Vannix R, Krafft P, Zouros A. Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma. J Surg Res [Internet]. 2017 [citado 30 enero 2022];219:366-373. doi: 10.1016/j.jss.2017.06.053
EMS management of patients with potential spinal injury. Ann of Emerg Med [Internet]. 2015 [citado 10 febrero 2022];66(4):445. Disponible en: 10.1016/j.annemergmed.2015.07.510
Hannon M, Mannix R, Dorney K, Mooney D, Hennelly K. Pediatric cervical spine injury evaluation after blunt trauma: a clinical decision analysis. Ann Emerg Med [Internet]. 2015 [citado 23 febrero 2022];65(3):239-247. Disponible en: 10.1016/j.annemergmed.2014.09.002
Kim W, Ahn N, Ata A, Adamo MA, Entezami P, Edwards M. Pediatric cervical spine injury in the United States: Defining the burden of injury, need for operative intervention, and disparities in imaging across trauma centers. J Pediatr Surg [Internet]. 2021 [citado 06 febrero 2022];56(2):293-296. Disponible en: 10.1016/j.jpedsurg.2020.05.009
Herman MJ, Brown KO, Sponseller PD, Phillips JH, Petrucelli PM, et al. Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group. J Bone Joint Surg Am [Internet]. 2019 [citado 10 febrero 2022] 2;101(1):e1. Disponible en: 10.2106/JBJS.18.00217
Copley PC, Tilliridou V, Kirby A, Jones J, Kandasamy J. Management of cervical spine trauma in children. Eur J Trauma Emerg Surg [Internet]. 2019 [citado 08 febrero 2022];45(5):777-789. Disponible en: 10.1007/s00068-018-0992-x
Caruso MC, Daugherty MC, Moody SM, Falcone RAJ, Bierbrauer KS, Geis GL. Lessons learned from administration of high-dose methylprednisolone sodium succinate for acute pediatric spinal cord injuries. J Neurosurg Pediatr [Internet]. 2017 [citado 10 febrero 2022]; 20(6):567-574. Disponible en: 10.3171/2017.7.PEDS1756
Poorman G, Segreto F, Beabrun B, Jalay C, Horn S, et al. Traumatic Fracture of the Pediatric Cervical Spine: Etiology, Epidemiology, Concurrent Injuries, and an Analysis of Perioperative Outcomes Using the Kids' Inpatient Database. Int J Spine Surg [Internet]. 2019 [citado 23 febrero 2022];13(1): 68-78. Disponible en: 10.14444/6009
Mortazavi M, Gore PA, Chang S, Tubbs RS, Theodore N. Pediatric cervical spine injuries: a comprehensive review. Childs Nerv Syst [Internet]. 2011 [citado 23 febrero 2022];27(5):705–717. Disponible en: 10.1007/s00381-010-1342-4
Romero-Arroyo AC, Ramirez-Morales G. Lesiones de columna vertebral y médula espinal en pediatría. Rev Mex Ortop Ped [Internet]. 2008 [citado 10 febrero 2022]; 10(1):14-19. Disponible en: https://www.medigraphic.com/pdfs/opediatria/op-2008/op081d.pdf
Anderson CJ, Kelly EH, Klass SJ, Russell H, Daharsh E, Vogel LC. Anxiety and depression in children and adolescents with spinal cord injuries. Dev Med Child Neurol [Internet]. 2009 [citado 06 febrero 2022];51(10):826-832. Disponible en: 10.1111/j.1469-8749.2009.03268.x
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