Jarvers Jan-Sven, Herren Christian, Jung Matthias K, Blume Christian, Meinig Holger, Ruf Michael, Disch Alexander C, Weiß Thomas, Rüther Hauke, Welk Thomas, Badke Andreas, Gonschorek Oliver, Heyde Christoph E, Kandziora Frank, Knop Christian, Kobbe Philipp, Scholz Matti, Siekmann Holger, Spiegl Ulrich, Strohm Peter, Strüwind Christoph, Matschke Stefan, Kreinest Michael
Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland.
Unfallchirurg. 2020 Apr;123(4):280-288. doi: 10.1007/s00113-020-00771-0.
In general, pediatric spinal injuries are rare. No reliable data on the epidemiology of spinal injuries in pediatric patients in Germany are available. Especially in pediatric patients, for whom the medical history, clinical examination and the performance of imaging diagnostics are difficult to obtain, all available information on a spinal injury must be taken into account.
The aim of this study was to provide epidemiological data for pediatric patients with spinal trauma in Germany in order to enhance future decision-making for the diagnostics and treatment of these patients.
Within the framework of a national multicenter study, data were retrospectively obtained from 6 German spine centers for 7 years between January 2010 and December 2016. In addition to the demographic data, the clinical databases were screened for specific trauma mechanisms, level of injury as well as accompanying injuries. Furthermore, diagnostic imaging and the treatment selected were also analyzed.
A total of 367 children (female: male = 1:1.2) with a total of 610 spinal injuries were included in this study. The mean age was 12 years (±3.5 years). The most frequent trauma mechanisms were falls from <3 m and traffic accidents. The imaging diagnostics were only rarely carried out with the child under anesthesia. Younger children (0-9 years old) suffered more injuries to the cervical spine, whereas injuries to the thoracic and lumbar spine were more frequently found in older children (>10 years old). The children frequently showed accompanying injuries to the head and the extremities. Accompanying spinal injuries mostly occurred in adjacent regions and only rarely in other regions. Around 75% of the children were treated conservatively.
The results were different from the knowledge obtained from adult patients with spinal trauma and describe the special circumstances for pediatric patients with spinal trauma. Despite certain limitations these facts may help to enhance future decision-making for the diagnostics and treatment of these patients.
一般来说，儿童脊柱损伤较为罕见。德国尚无关于儿科患者脊柱损伤流行病学的可靠数据。尤其是对于儿科患者，很难获取其病史、进行临床检查以及开展影像学诊断，因此必须考虑所有关于脊柱损伤的可用信息。
本研究旨在提供德国儿科脊柱创伤患者的流行病学数据，以改善未来对这些患者的诊断和治疗决策。
在一项全国多中心研究的框架内，回顾性收集了德国6个脊柱中心在2010年1月至2016年12月的7年间的数据。除人口统计学数据外，还在临床数据库中筛选了特定的创伤机制、损伤部位以及伴随损伤情况。此外，还对诊断性影像学检查和所选治疗方法进行了分析。
本研究共纳入367名儿童（女性：男性 = 1:1.2），共有610处脊柱损伤。平均年龄为12岁（±3.5岁）。最常见的创伤机制是从低于3米处坠落和交通事故。影像学诊断很少在患儿麻醉状态下进行。年幼儿童（0 - 9岁）颈椎损伤较多，而年长儿童（>10岁）胸椎和腰椎损伤更为常见。患儿常伴有头部和四肢损伤。脊柱伴随损伤大多发生在相邻区域，很少发生在其他区域。约75%的儿童接受了保守治疗。
研究结果与成人脊柱创伤患者的认知不同，描述了儿科脊柱创伤患者的特殊情况。尽管存在一定局限性，但这些事实可能有助于改善未来对这些患者的诊断和治疗决策。
