Saul Dominik, Dresing Klaus
Department of Trauma, Orthopedics and Reconstructive Surgery, Georg- August-University of Goettingen, Germany.
Pediatr Rep. 2018 Mar 29;10(1):7232. doi: 10.4081/pr.2018.7232. eCollection 2018 Mar 22.
Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating these patients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI). The study included 890 fractures in 546 patients with an average age of 12.8±6.2 (6.6-19.4) years. Females had an average age of 13.7±6.3 (7.4-20.0) years, whereas males were on average 12.0 (6.0-18.0) years old. Fall from height (58%) was the main cause of accident and the most common region of fracture was the thoracolumbar spine with a shift towards the thoracic spine the more fractures occurred. Merely 3.7% of all patients required operative treatment. If a vertebral fracture is found in children and adolescents, it is highly recommended to exclude synchronous additional spine fractures in other levels; prevention should concentrate on fall and traffic accidents.
儿童和青少年脊柱损伤虽属罕见损伤，但对正在生长的骨骼造成的后果可能是毁灭性的。了解事故原因、临床症状及诊断方法应是每个治疗此类患者的创伤科室的必备知识。我们对经影像学证实的脊柱椎体骨折患者进行了回顾性分析。经临床检查及初步诊断后，通过传统X线、计算机断层扫描（CT）或磁共振成像（MRI）证实骨折及损伤情况。该研究纳入了546例患者的890处骨折，患者平均年龄为12.8±6.2（6.6 - 19.4）岁。女性平均年龄为13.7±6.3（7.4 - 20.0）岁，而男性平均年龄为12.0（6.0 - 18.0）岁。高处坠落（58%）是主要事故原因，最常见的骨折部位是胸腰段脊柱，骨折发生越多，骨折部位越向胸椎转移。所有患者中仅3.7%需要手术治疗。如果在儿童和青少年中发现椎体骨折，强烈建议排除其他节段同步存在的额外脊柱骨折；预防应集中在预防坠落和交通事故方面。
