Ruge J R, Sinson G P, McLone D G, Cerullo L J
Division of Neurosurgery, Northwestern University, Chicago, Illinois.
J Neurosurg. 1988 Jan;68(1):25-30. doi: 10.3171/jns.1988.68.1.0025.
Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Clinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.
脊柱及脊柱支撑结构的成熟度是区分儿童与成人脊髓损伤的一个重要变量。本文呈现了71名12岁及以下儿童的临床数据，这些儿童占1972年6月至1986年6月期间作者所在机构收治的2598例脊髓损伤患者的2.7%。47例创伤性脊髓损伤儿童的平均年龄为6.9岁，其中包括20名女孩（43%）。小儿损伤的病因与成人损伤不同，跌倒为最常见的致病因素（38%），其次是与汽车相关的损伤（20%）。10名儿童（21.3%）有无放射学异常的脊髓损伤（SCIWORA），而27名（57%）有神经损伤证据。在所有创伤性小儿脊髓损伤中，19%出现完全性神经损伤，在SCIWORA患儿中这一比例为40%。脊髓损伤最常见的节段是C-2（27%，15例），其次是T-10（13%，7例）。经对数据进行统计学分析，出现了一个3岁及以下的儿童亚组。与4至12岁儿童相比，这些非常年幼的儿童在损伤节段、手术稳定性需求及性别分布方面存在显著差异。
