Clinical analyses of cervical spine injury in 62 children

Objective To discuss the characteristics, strategies and methods of individualized diagnosis and surgical treatment of cervical spine injury in children. Methods A total of 62 children of cervical spinal injury were analyzed retrospectively from March 2002 to December 2012. There were 48 boys and 14 girls with an average age of 7. 5 （3 - 12） years. Among them, the ages were 3 - 6 years （n = 25） and 7- 12 years （n = 37）. The average visiting time after injury was 5. 5 weeks （1 day to 50 weeks）. Among 36 cases at C0-3, there were atlas transverse ligament rupture （n = 2） ; atlantoaxial rotatory fixation or dislocation （n = 26） and odontoid synchondrosis fracture （n = 4） ; for 17 cases at C4-7; spinal cord injuries without any fracture and dislocation were found in 9 cases. According to different conditions, they received Glission belt or skull traction and Halo-Vest support, head-neck- chest plaster, Dick splint or Philadelphia collar external fixation, methylprednisolone （MP） impact therapy and surgery, Results The interventions included surgical operation （n = 14）, skull traction or head and neck chest orthosis （n = 45） and no special measure （n = 3）. The average hospitalization stay was 16 （9 - 40） days. During an average follow-up period of 25 （2 - 69） months, all patients achieved excellent clinical efficacies. Conclusions Anatomical structure and biomechanics of cervical spine in children undergo dynamic developments. Therefore injury mechanism, clinical representation and surgical strategy in children are different from those in adults. Surgery should be individualized and operative indication strictly controlled. Key words: Cervical vertebrae; Traction;  External fixators