Cao Romero AA, Ramírez MG

Language: Spanish
References: 14
Page: 14-19
PDF size: 285.05 Kb.

ABSTRACT

Introduction: Fractures of the spine in skeletally immature patients differ from those seen in adults in the fracture pattern, the etiology, the incidence and the treatment. Children have a higher incidence of spinal cord injuries without evidence of radiographic abnormality, related to the relative hypermobility of the spine. Material and methods: This is a retrospective revision of patients under 19 years presenting with a spinal injury seen at our institutions between May of 1998 and May of 2006 who had a minimum follow-up of one year. Twenty-five patients were reviewed (14 males and 11 females). Mean age was 14 years and 7 months at the time of injury. The cause, fracture pattern, and neurologic status as determined with the ASIA scale were documented. Results: The causes were as follows: 11 were falls (from 3 to 15 meters high), 9 were motor vehicle accidents (4 overturns, 3 front-on collisions and 2 vehicle-pedestrian collisions), 3 were direct blunt trauma and 2 were gunshot injuries. The level of the injury was cervical in 4 cases, thoracic in 9 cases and lumbosacral in 12 cases. The neurologic status according to the ASIA scale was level A in 6 cases, level B in 1 case, level D in 3 cases and level E in 15 cases, with no level C.

REFERENCES

1. Adran GM, Kemp FH. The mechanism of changes in the form of cervical airway in infancy. Med Radiogr Photogr 1968; 44: 26-38.

2. Ruge JR, Sinson GP, Mc Lone DG et al. Pediatric spinal injury: The very young. J Neurosurg 1988; 68: 25-30.

3. Hadley MN, Zambraski JM, Browner CM et al. Pediatric spinal trauma. Review of 122 cases of spinal cord and vertebral column injuries. J Neurosurg 1988; 68: 18-24.

4. Koch BM, Neg GM. Neonatal spinal cord injury. Arch Phys Med Rehabil 1979; 60: 378-381.

5. Smart PJE, Hardy PJ, Buckley DMG, Somers JM, Broderick NJ, Halliday KE, Williams L. Cervical spine injuries to children under 11: Should we use radiography more selectively in their initial assessment? British Medical Journal 2003; 20(3): 225-227.

6. Dormans JP. Evaluation of children with suspected cervical spine injury. The Journal of Bone and Joint Surgery. 2002; 84-A(1): 124-132.

7. Finch GD, Barnes MJ. Major cervical spine injuries in children and adolescents, Journal of Pediatric Orthopaedics. 1998 Lippincott Williams & Wilkins, Inc. 1998; 18(6): 811-814.

8. Pouliquen JC, Kassis B, Glorion C, Langlais J. Vertebral growth after thoracic or lumbar fracture of the spine in children; Journal of Pediatric Orthopaedics, Lippincott-Raven Publishers. 1997; 17(1): 115-120.

9. McGrory BJ, Klassen RA, Chao EYS, Staeheli JW, Weaver AL. Acute fractures and dislocations of the cervical spine in children and adolescents; The Journal of Bone and Joint Surgery. 1993; 75-A(7): 988-995.

10. Martin BW, Dykes E, Lecky FE.; Archives of disease in childhood; BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 2004; 89(9): 860-865.

11. Mattera CJ. Spinal trauma: New guidelines for assessment and management in the out-of-hospital environment; 1998 by the Emergency Nurses Association. 1998; 24(6): 523-538.

12. Terry Canale S. Cirugía ortopédica, 9a edición, Edit. Harcourt Brace. 1998; 3: 2705.

13. Rothman-Simeone. Columna vertebral, Cuarta edición volumen II, edit. Mc Graw-Hill Interamericana, 1999: 931.

14. Pockwood-Wilkins. Fracturas en el niño. Quinta edición, Edit. Marbán año 2003: 809.