Jarvers Jan-Sven, Herren Christian, Jung Matthias K, Blume Christian, Meinig Holger, Ruf Michael, 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, Disch Alexander C, Kreinest Michael
Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Germany.
Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Aachen, Germany.
Eur Spine J. 2023 Apr;32(4):1291-1299. doi: 10.1007/s00586-023-07532-8. Epub 2023 Feb 9.
The aim of this study was to provide epidemiological data of pediatric patients suffering from cervical spinal trauma in Germany, in order to integrate these data in future decision-making processes concerning diagnosis and therapy.
Retrospective multicenter study includes all patients up to 16 years suffering from cervical spine injuries who were treated in six German spine centers between 01/2010 and 12/2016. The clinical databases were screened for specific trauma mechanism, level of injury as well as accompanying injuries. Diagnostic imaging and the chosen therapy were analyzed. Patients were divided into three age groups for further evaluation: age group I (0-6 years), age group II (7-9 years), age group III (10-16 years).
A total of 214 children with 265 cervical spine injuries were included during the mentioned period. The mean age at the time of injury was 11.9 (± 3.9) years. In age group I, 24 (11.2%) patients were included, age group II consisted of 22 patients (10.3%), and 168 patients belonged to age group III (78.5%). Girls and boys were equally affected. In all age groups, falls and traffic accidents were the most common causes of cervical spine injuries. A total of 180 patients (84.1%) were treated conservatively, while 34 (15.9%) children underwent surgery. Distorsion/whiplash injury was the most common entity (n = 165; 68.2%). Children aged 0-9 years had significantly (p < 0.001) more frequent injuries of the upper cervical spine (C0-C2) compared to older age groups. Patients of age group III were more likely to suffer from injuries in subaxial localizations. Neurological deficits were rarely seen in all age groups. Head injuries did represent the most common accompanying injuries (39.8%, n = 92).
The upper cervical spine was more frequently affected in young children. Older children more often suffered from subaxial pathologies. The majority of cervical spinal column injuries were treated conservatively. Nevertheless, 15% of the hospitalized children had to be treated surgically.
本研究旨在提供德国儿童颈椎创伤的流行病学数据，以便将这些数据纳入未来有关诊断和治疗的决策过程。
回顾性多中心研究纳入了2010年1月至2016年12月期间在德国六个脊柱中心接受治疗的所有16岁以下颈椎损伤患者。对临床数据库进行筛查，以获取特定的创伤机制、损伤水平以及伴随损伤情况。分析诊断性影像学检查和所采用的治疗方法。将患者分为三个年龄组进行进一步评估：年龄组I（0 - 6岁）、年龄组II（7 - 9岁）、年龄组III（10 - 16岁）。
在上述期间，共纳入214例患有265处颈椎损伤的儿童。受伤时的平均年龄为11.9（±3.9）岁。年龄组I纳入24例（11.2%）患者，年龄组II有22例患者（10.3%），168例患者属于年龄组III（78.5%）。女孩和男孩受影响程度相同。在所有年龄组中，跌倒和交通事故是颈椎损伤最常见的原因。共有180例患者（84.1%）接受了保守治疗，而34例（15.9%）儿童接受了手术治疗。扭伤/挥鞭样损伤是最常见的类型（n = 165；68.2%）。与年龄较大的年龄组相比，0 - 9岁儿童上颈椎（C0 - C2）损伤明显更频繁（p < 0.001）。年龄组III的患者更易发生下颈椎部位的损伤。在所有年龄组中，神经功能缺损很少见。头部损伤是最常见的伴随损伤（39.8%，n = 92）。
幼儿中上颈椎更常受到影响。年龄较大的儿童更常患有下颈椎病变。大多数颈椎损伤采用保守治疗。然而，15%的住院儿童必须接受手术治疗。
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