Parente A, Navascués J A, Hernández E, Sánchez-París O, Cañizo A, Cerdá J, Molina E, De Tomás E, De Agustín J C, Matute J A, Vázquez J
Servicio de Cirugía Pediátrica. Hospital Infantil Gregorio Marañón, Madrid.
Cir Pediatr. 2005 Jul;18(3):132-5.
Analysis of main factors of spinal cord and vertebral column injuries in our environment.
We reviewed the data collected from the patients (n = 2640) admitted to our hospital because of trauma and included in our Registry from January 1995 to April 2002. Among this group, 86 patients (3.3%) had spinal cord and vertebral column injuries and were included in the study.
Group gender distribution was 45 males and 41 females. In our group, 71 patients suffered vertebral fractures, 3 of them with spinal cord injuries (4.2%), 13 patients with vertebral subluxation, 11 of them between C1-C2, and 2 patients with spinal cord injury without radiographic abnormality. Only 71 patients, 4.9% of the total of the patients who were admitted with any type of fracture (n=1457), suffered vertebral fractures. These patients suffered 130 vertebral fractures, 35 of them (49.3%) suffered multiple fractures. Thoracic vertebrae were the most frequently affected (n=82, 63%). The most frequent localization was T4 toT8 (n=50, 38.5% and T11 to L2 (n=41, 31.5%). Age ranged between 12 and 15 years (n=35, 49.3%), with only 5 patients under 6 years. 90.9% of the patients with lumbar fractures were older than 8 years and 76.9% of the patients with cervical fractures were over 8 years. Motor vehicle accident was the most common cause in our series (n=20, 23.3%). 81% of these patients did not use safety belt. Ten children with cervical injuries were seen by medical staff at the prehospital stage, and only 4 of them arrived to Hospital with cervical collar. There were thirty five patients with thoracic or lumbar injuries but only 27 of them were transferred to our Institution by ambulance. Surgery was required in 2 patients, both of them with unstable fractures. Mean hospital stay was 17,1 days (range 2-37 days).
Group gender distribution is similar between males and females and the incidence in our series is higher than other series of the literature. Thoracic injuries are the most frequent. It is necessary to improve prehospital management of these patients and to increase the use of safety belt. Spine injury incidence increased with age.
分析我们所处环境中脊髓和脊柱损伤的主要因素。
我们回顾了1995年1月至2002年4月期间因创伤入院并纳入我们登记系统的患者（n = 2640）的数据。在这组患者中，86例（3.3%）有脊髓和脊柱损伤并被纳入研究。
该组性别分布为45例男性和41例女性。在我们组中，71例患者发生椎体骨折，其中3例伴有脊髓损伤（4.2%），13例患者有椎体半脱位，其中11例在C1 - C2之间，2例患者有脊髓损伤但影像学无异常。在因任何类型骨折入院的患者总数（n = 1457）中，只有71例患者（4.9%）发生椎体骨折。这些患者共发生130处椎体骨折，其中35例（49.3%）为多发性骨折。胸椎是最常受累的部位（n = 82，63%）。最常见的部位是T4至T8（n = 50，38.5%）和T11至L2（n = 41，31.5%）。年龄在12至15岁之间（n = 35，49.3%），6岁以下仅有5例。腰椎骨折患者中90.9%年龄大于8岁，颈椎骨折患者中76.9%年龄超过8岁。机动车事故是我们系列中最常见的原因（n = 20，23.3%）。这些患者中81%未使用安全带。10例颈椎损伤儿童在院前阶段被医护人员诊治，其中只有4例戴着颈托到达医院。有35例胸腰椎损伤患者，但只有27例通过救护车转至我们机构。2例患者需要手术，均为不稳定骨折。平均住院时间为17.1天（范围2至37天）。
该组男女性别分布相似，我们系列中的发病率高于文献中的其他系列。胸段损伤最为常见。有必要改善这些患者的院前管理并增加安全带使用率。脊柱损伤发病率随年龄增加而上升。
