Shigemori M, Tokutomi T, Yuge T, Yamamoto F, Kuramoto S
Department of Neurosurgery, Kurume University School of Medicine.
No Shinkei Geka. 1989 Sep;17(9):855-60.
We reported five cases of children with spinal injuries. Spinal injuries are rare in children, and most common from the occiput to C3 in children younger than 8 years. In our cases, two younger children had upper cervical lesions and two older children had lower lesions. These differences result from anatomical characteristics, such as special histological architecture of the growth zones in younger children. One patient had a delayed onset paraplegia without radiographic abnormality. This phenomenon seems to be one of the characteristics of the spinal injuries in children. Because of this, all children with head or neck injuries should be fully investigated. A nine-month-old child who suffered from a fracture of the odontoid process with atlantoaxial dislocation was treated by immobilization only, and the result was good. Generally, fracture of the odontoid process in young children can be treated by proper immobilization. One patient with fracture dislocation of the cervical spine died as a result of cord injury. So immediate surgical decompression is mandatory for patients with evidence of cord compression.
我们报告了5例儿童脊柱损伤病例。脊柱损伤在儿童中较为罕见，在8岁以下儿童中最常见于枕部至C3节段。在我们的病例中，两名年龄较小的儿童有上颈椎损伤，两名年龄较大的儿童有下颈椎损伤。这些差异源于解剖学特征，比如年幼儿童生长区特殊的组织学结构。一名患者出现延迟性截瘫，影像学检查无异常。这种现象似乎是儿童脊柱损伤的特征之一。因此，所有头部或颈部受伤的儿童都应进行全面检查。一名9个月大的儿童患有齿突骨折伴寰枢椎脱位，仅通过固定治疗，结果良好。一般来说，幼儿齿突骨折可通过适当固定进行治疗。一名颈椎骨折脱位患者因脊髓损伤死亡。因此，对于有脊髓受压证据的患者，立即进行手术减压是必要的。
