scholarly journals Cervical spine trauma in children: a review

2006 ◽  
Vol 20 (2) ◽  
pp. 1-8 ◽  
Author(s):  
Todd McCall ◽  
Dan Fassett ◽  
Douglas Brockmeyer
Keyword(s):  
Cervical Spine ◽  
Growth Potential ◽  
Pediatric Spine ◽  
Older Children ◽  
High Complication Rate ◽  
Traumatic Injuries ◽  
Cord Injury ◽  
Upper Cervical ◽  
Surgical Options ◽  
Cervical Injuries

✓ Injuries of the cervical spine are relatively rare in children but are a distinct clinical entity compared with those found in adults. The unique biomechanics of the pediatric cervical spine lead to a different distribution of injuries and distinct radiographic features. Children younger than 9 years of age usually have upper cervical injuries, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. Pediatric cervical injuries are more frequently ligamentous in nature, and children are also more prone to spinal cord injury without radiographic abnormality than adults are. Physial injuries are specific only to children. Radiographically benign findings, such as pseudosubluxation and synchondrosis, can be mistaken for traumatic injuries. External immobilization with a halo brace can be difficult and is associated with a high complication rate because of the thin calvaria in children. Surgical options have improved with the development of instrumentation specifically for children, but special considerations exist, such as the small size and growth potential of the pediatric spine.

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

2021 ◽  
pp. 1-7
Author(s):  
Marko Jug
Keyword(s):  
Cervical Spine ◽  
3D Model ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Upper Cervical Spine ◽  
Spine Instrumentation ◽  
Cord Injury ◽  
Spinal Navigation ◽  
Upper Cervical ◽  
3D Printed

<b><i>Introduction:</i></b> In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. <b><i>Case Presentation:</i></b> We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. <b><i>Discussion/Conclusion:</i></b> Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

Craniovertebral junction injuries in children. A Review

2007 ◽  
Vol 04 (02) ◽  
pp. 79-87 ◽  
Author(s):  
Abrar Ahad Wani ◽  
Tanveer A Dar ◽  
Altaf Umar Ramzan ◽  
Altaf Rehman Kirmani ◽  
Abdul Rasheed Bhatt
Keyword(s):  
Cervical Spine ◽  
Craniovertebral Junction ◽  
Minor Trauma ◽  
Movement Restriction ◽  
Wide Range ◽  
Cord Injury ◽  
Upper Cervical ◽  
Progressive Neurological Deficit ◽  
History Of ◽  
Transient Loss

AbstractThe craniovertebral junction (CVJ) is the most complex and dynamic region of the cervical spine. The wide range of movements possible at this region makes it vulnerable to injury and instability. The special anatomical features make children more prone to injuries of CVJ than adults where lower cervical spine is involved more frequently. The classical clinical manifestation in CVJ injury patients are pyramidal signs including weakness and spasticity, stigmata of CVJ anomalies (short neck, low hair line, facial or hand asymmetry, high arched palate, ), torticolis and neck movement restriction. The history of transient loss of consciousness or sudden neurological deterioration following minor trauma may be elicited. Most authors advocate conservative management (in form of immobilization) of CVJ injuries in children as is true in adults. Halo vest provides superior immobilization in upper cervical and CVJ injuries and can be used in a child as young as 1 year of age with minimal difficulty. Early surgical intervention, i.e. within 2 weeks of injury include is indicated in injuries that cannot be reduced and stabilized by external means, partial spinal cord injury with progressive neurological deficit and in children with extradural hematoma.

Pediatric neck injuries

1984 ◽  
Vol 60 (4) ◽  
pp. 700-706 ◽  
Author(s):  
Stephen A. Hill ◽  
Carole A. Miller ◽  
Edward J. Kosnik ◽  
William E. Hunt
Keyword(s):  
Motor Vehicle ◽  
Spinal Column ◽  
Neurological Deficits ◽  
Neck Injuries ◽  
Older Children ◽  
Content Type ◽  
Vehicle Accidents ◽  
Upper Cervical ◽  
Cervical Injuries ◽  
Fine Print

✓ This review of pediatric neck injuries includes patients admitted to Children's Hospital of Columbus, Ohio, during the period 1969 to 1979. The 122 patients with neck injuries constituted 1.4% of the total neurosurgical admissions during this time. Forty-eight patients had cervical strains; 74 had involvement of the spinal column; and 27 had neurological deficits. The injuries reached their peak incidence during the summer months, with motor-vehicle accidents accounting for 31%, diving injuries and falls from a height 20% each, football injuries 8%, other sports 11%, and miscellaneous 10%. There is a clear division of patients into a group aged 8 years or less with exclusively upper cervical injuries, and an older group with pancervical injuries. In the younger children, the injuries involved soft tissue (subluxation was seen more frequently than fracture), and tended to occur through subchondral growth plates, with a more reliable union than similar bone injuries. In the older children, the pattern and etiology of injury are the same as in adults. The entire cervical axis is at risk, and there is a tendency to fracture bone rather than cartilaginous structures.

A review of pediatric lumbar spine trauma

2014 ◽  
Vol 37 (1) ◽  
pp. E6 ◽  
Author(s):  
Christina Sayama ◽  
Tsulee Chen ◽  
Gregory Trost ◽  
Andrew Jea
Keyword(s):  
Lumbar Spine ◽  
Bone Fractures ◽  
Spine Injury ◽  
Lumbar Region ◽  
Pediatric Spine ◽  
Older Children ◽  
Radiographic Findings ◽  
Injury Treatment ◽  
Cervical Injuries ◽  
Adult Spine

Pediatric spine fractures constitute 1%–3% of all pediatric fractures. Anywhere from 20% to 60% of these fractures occur in the thoracic or lumbar spine, with the lumbar region being more affected in older children. Younger children tend to have a higher proportion of cervical injuries. The pediatric spine differs in many ways from the adult spine, which can lead to increased ligamentous injuries without bone fractures. The authors discuss and review pediatric lumbar trauma, specifically focusing on epidemiology, radiographic findings, types and mechanisms of lumbar spine injury, treatment, and outcomes.

Nonoperative Management of Vertical C2 Body Fractures

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 516-521 ◽  
Author(s):  
John W. German ◽  
Blaine L. Hart ◽  
Edward C. Benzel
Keyword(s):  
Cervical Spine ◽  
Nonoperative Management ◽  
Upper Cervical Spine ◽  
Cervical Spine Injuries ◽  
Body Fracture ◽  
Cord Injury ◽  
Spine Injuries ◽  
Upper Cervical

Abstract OBJECTIVE: To estimate the incidence and to describe the clinical results of the nonoperative management of vertical C2 body fractures. METHODS: An 8-year retrospective review of upper cervical spine injuries from the registry of a level I trauma center identified 21 patients with a vertical C2 body fracture. RESULTS: Sixteen coronally oriented Type 1 vertical C2 body fractures and 5 sagittally oriented Type 2 vertical C2 body fractures were identified. These fractures account for approximately 10% of the upper cervical spine fractures identified over this period of time. One elderly patient with a Type 1 fracture died as a result of pneumonia, and two patients with Type 2 fractures died from severe closed-head injuries. One patient had evidence of spinal cord injury. This was not related to the C2 body fracture but rather to a subaxial cervical spine injury. Of the surviving 18 patients, all were managed nonoperatively (with external orthoses) and showed evidence of fusion (union of fracture fragments) at the time of the last follow-up. CONCLUSION: Vertical C2 body fractures are not rare injuries and can account for up to 10% of upper cervical spine injuries. In general, vertical C2 body fractures are amenable to nonoperative treatment with external orthoses.

Endonasal Surgery of the Upper Cervical Spine: A Morphometric Analysis

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Harminder Singh ◽  
Bartosz Grobelny ◽  
Adam Flanders ◽  
Marc Rosen ◽  
Paul Schiffmacher ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Morphometric Analysis ◽  
Upper Cervical Spine ◽  
Endonasal Surgery ◽  
Upper Cervical

CERVICAL SPINE AND CORD INJURY WITH OCCLUSION AND STENOSIS OF VERTEBRAL ARTERIES/A CASE REPPRT

1993 ◽  
Vol 43 (4) ◽  
pp. 439-445
Author(s):  
TADAO MATSUSHIMA ◽  
HIROSHI NAKAGAWA ◽  
JINICHI KOIZUMI ◽  
KAZUO WATANABE
Keyword(s):  
Cervical Spine ◽  
Vertebral Arteries ◽  
Cord Injury

scholarly journals Age-Dependent Decline in Neuron Growth Potential and Mitochondria Functions in Cortical Neurons

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1625
Author(s):  
Theresa C. Sutherland ◽  
Arthur Sefiani ◽  
Darijana Horvat ◽  
Taylor E. Huntington ◽  
Yuanjiu Lei ◽  
...  
Keyword(s):  
Cortical Neurons ◽  
Traumatic Injury ◽  
Axon Growth ◽  
Neurite Growth ◽  
Growth Potential ◽  
Mitochondrial Functions ◽  
Cord Injury ◽  
Age Dependent ◽  
Mitochondria Functions ◽  
The Impact

The age of incidence of spinal cord injury (SCI) and the average age of people living with SCI is continuously increasing. However, SCI is extensively modeled in young adult animals, hampering translation of research to clinical applications. While there has been significant progress in manipulating axon growth after injury, the impact of aging is still unknown. Mitochondria are essential to successful neurite and axon growth, while aging is associated with a decline in mitochondrial functions. Using isolation and culture of adult cortical neurons, we analyzed mitochondrial changes in 2-, 6-, 12- and 18-month-old mice. We observed reduced neurite growth in older neurons. Older neurons also showed dysfunctional respiration, reduced membrane potential, and altered mitochondrial membrane transport proteins; however, mitochondrial DNA (mtDNA) abundance and cellular ATP were increased. Taken together, these data suggest that dysfunctional mitochondria in older neurons may be associated with the age-dependent reduction in neurite growth. Both normal aging and traumatic injury are associated with mitochondrial dysfunction, posing a challenge for an aging SCI population as the two elements can combine to worsen injury outcomes. The results of this study highlight this as an area of great interest in CNS trauma.

scholarly journals Outcome of Cervical Spine Trauma Patients Admitted to the Intensive Care Unit at a Tertiary Government Referral Trauma Center in Nepal

2021 ◽  
pp. 219256822098070
Author(s):  
Gyanendra Shah ◽  
Gaurav Raj Dhakal ◽  
Anil Gupta ◽  
Pawan Kumar Hamal ◽  
Siddhartha Dhungana ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Limited Resource ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Resource Setting ◽  
Cord Injury ◽  
Huge Impact

Study Design: Retrospective study. Objectives: Cervical spinal cord injury (SCI) is a devastating event for patient and family. It has a huge impact on society because of intensive resources required to manage the patient in both acute and rehabilitation phases. With the limited resource setting in underdeveloped countries like Nepal, questions are often raised regarding whether the outcome justifies the expenses of their care. The objective was to assess the outcomes of cervical SCI patients admitted to intensive care unit (ICU). Methods: All cervical SCI admitted in ICU during May 2017 to August 2018 were included in this study. Demographic details, mode, morphology, and neurological level of injury, intervention performed and outcomes of ICU stay were analyzed. Results: Out of 48 patients, 36 (75%) were male and 12 female with mean age 43.9 ± 15.9 years. Fall injury was the commonest mode of injury (83.3%). Most patients presented within 1 to 3 days of injury and C5-C6 (33.3%) was the most common involved level and 75% presented with ASIA A neurology. Mechanical ventilation was required in 95.8% of the patients and 22 patients were operated upon. The average stay in ICU was 15 days and 13 patients died in the ICU. Conclusions: Majority of cervical SCI with complete motor paraplegia required ICU care. Inspite of the intensive care, a subset of these patients succumbed to the complications of the injury. Therefore, it is essential to establish trauma ICU care with specific protocols on managing cervical spine injuries.

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