Angulo Tabernero Marina, Suñén Sánchez Enrique, Peña Jiménez Diego, Loste Ramos Antonio, Tabuenca Sánchez Antonio, Chárlez Marco Alfredo, Rodríguez Vela Javier
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Rev Fac Cien Med Univ Nac Cordoba. 2017 Sep 14;74(3):288-292. doi: 10.31053/1853.0605.v74.n3.12863.
Cervical spine injury is rare in children. It is seen primarily in those who sustain significant, severe blunt trauma, occurring in 1 to 2 percent of such cases. The interpretation of cervical spine radiographs and the clinical examination in children may be difficult.The objective of this case clinic is to report on a physiological radiographic finding of the cervical spine in childhood that trends to be misjudged as pathologic: C2-C3 pseudosubluxation. We presented a boy, aged 5 years, who came to our Traumatic pediatric emergency center for cervical pain after falling from a height. In lateral radiographs we observed a disruption of the alignment of the anterior and posterior vertebral body line in C2-C3 space. A detailed anamnesis as well as a meticulous radiological and clinical exploration, allow to establish the right diagnosis in most cases, without any other complementary probe. Pseudosubluxation of C2 anterior to C3 is seen in approximately 40 percent of children under the age of 8 years. Pseudosubluxation can be differentiated from true subluxation by evaluating the spinolaminal line (Swischuk), line between the anterior aspects of the C1 and C3 spinous processes. The suitable radiographic interpretation of the cervical spine in children requires the knowledge of the peculiarities of this segment in the pediatric age.
儿童颈椎损伤较为罕见。主要见于遭受严重钝性创伤的儿童,在这类病例中发生率为1%至2%。儿童颈椎X光片的解读和临床检查可能存在困难。本病例报告的目的是汇报一种在儿童期颈椎的生理性影像学表现,这种表现易被误诊为病理性表现:C2-C3假性半脱位。我们介绍一名5岁男孩,他从高处坠落后来到我们的创伤儿科急诊中心,主诉颈部疼痛。在侧位X光片中,我们观察到C2-C3间隙椎体前后缘连线排列中断。详细的病史采集以及细致的影像学和临床检查,在大多数情况下无需其他辅助检查即可做出正确诊断。8岁以下儿童中约40%可见C2相对于C3的假性半脱位。通过评估棘突间线(斯维舒克线),即C1和C3棘突前缘之间的连线,可将假性半脱位与真性半脱位区分开来。对儿童颈椎进行恰当的影像学解读需要了解该节段在儿童时期的特点。