Konovalov Nikolay, Peev Nikolay, Zileli Mehmet, Sharif Salman, Kaprovoy Stanislav, Timonin Stanislav
Burdenko Institute Department of Neurosurgery, Moscow, Russian Federation.
Department of Neurosurgery, Belfast Health and Social Care Trust, Northern Ireland, Belfast, UK.
Neurospine. 2020 Dec;17(4):797-808. doi: 10.14245/ns.2040404.202. Epub 2020 Dec 31.
Cervical trauma in children have variations from the adults mainly due to anatomic differences. An optimal diagnostic and treatment strategy is critical, particularly when there is a lack of standardized protocols for the management of such cases. This review paper examines the diagnostic and treatment options of pediatric cervical trauma and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA). A literature search for the last 10 years were conducted using key words. Case reports, experimental studies, papers other than English language were excluded. Up-to-date information on pediatric cervical trauma and SCIWORA were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of WFNS Spine Committee. The statements were voted and reached a consensus using Delphi method. This review reflects different aspects of contemporary pediatric cervical trauma decision-making and treatment, and SCIWORA. The mainstay of SCIWORA treatment is nonsurgical with immobilization, avoidance of risky activities. Prognosis generally depends on the initial neurological status and magnetic resonance imaging. Due to a significant discrepancy in the literature on diagnostic and management, future randomized controlled trials are needed to aid in generating standardized protocols.
儿童颈椎创伤与成人有所不同，主要是由于解剖学差异。最佳的诊断和治疗策略至关重要，尤其是在缺乏此类病例管理标准化方案的情况下。这篇综述文章探讨了儿童颈椎创伤和无放射学异常的脊髓损伤（SCIWORA）的诊断和治疗选择。使用关键词对过去10年的文献进行了检索。排除了病例报告、实验研究以及非英语语言的论文。对儿童颈椎创伤和SCIWORA的最新信息进行了综述，并在世界神经外科联合会脊柱委员会的两次单独共识会议上达成了共识声明。这些声明采用德尔菲法进行投票并达成共识。本综述反映了当代儿童颈椎创伤决策和治疗以及SCIWORA的不同方面。SCIWORA治疗的主要方法是非手术治疗，包括固定、避免危险活动。预后通常取决于初始神经状态和磁共振成像。由于文献中关于诊断和管理存在显著差异，未来需要进行随机对照试验以帮助制定标准化方案。
