Cirak Bayram, Ziegfeld Suzan, Knight Vinita Misra, Chang David, Avellino Anthony M, Paidas Charles N
Pediatric Division, Department of Neurosurgery; Johns Hopkins Medical Institutions, Baltimore, MD, USA.
J Pediatr Surg. 2004 Apr;39(4):607-12. doi: 10.1016/j.jpedsurg.2003.12.011.
BACKGROUND/PURPOSE: Traumatic spinal injury (TSI) is an uncommon source of morbidity and mortality in children. The aim of this study was to describe childhood TSI in a single level 1 urban pediatric trauma center.
The authors retrospectively analyzed all children younger than 14 years with TSI, treated at a level I pediatric trauma center between 1991 and 2002 (n = 406, 4% total registry). All children were stratified according to demographics, mechanisms, type and level of injury, radiologic evaluations, associated injuries, and mortality.
The mean age was 9.48 +/- 3.81 years. The most common overall mechanism of injury was motor vehicle crash (MVC; 29%) and ranked highest for infants. Falls ranked highest for ages 2 to 9 years. Sports ranked highest in the 10 to 14 year age group. Paravertebral soft tissue injuries were 68%. The most common injury level was the high cervical spine (O-C4). The incidence of spinal cord injury without radiologic abnormality (SCIWORA) was 6%. Traumatic brain injury (37%) was the most common associated injury. Overall mortality rate was 4% in this urban catchment.
TSI in children requires a different preventive and therapeutic logarithm compared with that of adults. The potential devastating nature of TSI warrants that the health care team always maintains a high index of suspicion for injury. Future prospective studies are needed to further elucidate injury patterns.
背景/目的：创伤性脊髓损伤（TSI）在儿童中是一种不常见的发病和死亡原因。本研究的目的是描述一家一级城市儿科创伤中心的儿童TSI情况。
作者回顾性分析了1991年至2002年间在一家一级儿科创伤中心接受治疗的所有14岁以下TSI儿童（n = 406，占总登记人数的4%）。所有儿童均根据人口统计学、损伤机制、损伤类型和水平、放射学评估、相关损伤及死亡率进行分层。
平均年龄为9.48±3.81岁。最常见的总体损伤机制是机动车碰撞（MVC；29%），在婴儿中排名最高。跌倒在2至9岁年龄段排名最高。运动在10至14岁年龄组中排名最高。椎旁软组织损伤占68%。最常见的损伤水平是高位颈椎（O - C4）。无放射学异常的脊髓损伤（SCIWORA）发生率为6%。创伤性脑损伤（37%）是最常见的相关损伤。在这个城市地区，总体死亡率为4%。
与成人相比，儿童TSI需要不同的预防和治疗方案。TSI潜在的毁灭性性质要求医疗团队始终对损伤保持高度怀疑指数。未来需要进行前瞻性研究以进一步阐明损伤模式。
