Madura Casey J, Johnston James M
Division of Pediatric Neurosurgery, Department of Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder Suite 400, Birmingham, Alabama 35233, USA.
Division of Pediatric Neurosurgery, Department of Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder Suite 400, Birmingham, Alabama 35233, USA.
Neurosurg Clin N Am. 2017 Jan;28(1):91-102. doi: 10.1016/j.nec.2016.07.004.
Appropriate management of subaxial spine injury in children requires an appreciation for the differences in anatomy, biomechanics, injury patterns, and treatment options compared with adult patients. Increased flexibility, weak neck muscles, and cranial disproportion predispose younger children to upper cervical injuries and spinal cord injury without radiographic abnormality. A majority of subaxial cervical spine injuries can be treated nonoperatively. Surgical instrumentation options for children have significantly increased in recent years. Future studies of outcomes for children with subaxial cervical spine injury should focus on injury classification and standardized outcome measures to ensure continued improvement in quality of care for this patient population.
儿童下颈椎损伤的恰当处理需要认识到与成年患者相比,在解剖结构、生物力学、损伤模式和治疗选择上的差异。柔韧性增加、颈部肌肉薄弱以及头颅比例失调使年幼儿童更易发生上颈椎损伤和无放射学异常的脊髓损伤。大多数下颈椎损伤可采用非手术治疗。近年来,儿童手术内固定的选择已显著增加。未来关于儿童下颈椎损伤预后的研究应聚焦于损伤分类和标准化的预后指标,以确保该患者群体的医疗质量持续改善。