Oude Alink Michelle, Stassen Huub, Spoor Jochem, Renkens Jeroen, Moors Xavier, Dremmen Marjolein, Stolker Robert Jan, van der Marel Caroline
Department of Anesthesiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Department of Neurosurgery, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2024 Apr 18;13(8):2372. doi: 10.3390/jcm13082372.
: Traumatic spinal injury in children is a rare but serious life event. Predicting pediatric patients at risk for spinal injury remains difficult. This study focuses on the cause of the injury and predictors to identify children at risk and appropriate diagnostic procedures. : Retrospective chart review from the Landelijke Trauma Registratie of patients with spinal injury from 2010 to 2021 in a level 1 pediatric trauma center. : We included 114 children with spinal injury, 79.8% of whom were aged 12-17 years. In the overall trauma population, the incidence of spinal injury was 10% in children aged 12-17 years, 2.3% in children aged 6-11 years, and 0.4% in children 0-5 years of age. Neurological deficits were present in 27.2% of patients in the emergency department, with permanent deficits in 14.0%. Spinal fractures were present in 91.2% of 12-17-year-olds, 43.8% in 6-11-year-olds, and 71.4% in 0-5-year-olds. ISS was 23 (SD 14) in children with spinal injury compared to 8 (SD 9) for children without spinal injury. : In children 0-11 years old, spinal injury is very rare compared to the overall trauma population, and there are more non-osseous injuries. Clinicians should consider MRI as the next step after conventional X-ray to diagnose or exclude spinal injuries in this group. In older children aged 12-17 years, the incidence of spinal injury is much higher, at 10%. Although ISS is higher in children with spinal injury, a low ISS does not exclude spinal injury. If one fracture is found, more fractures in other regions of the spine may be present.
儿童创伤性脊髓损伤是一种罕见但严重的危及生命的事件。预测有脊髓损伤风险的儿科患者仍然很困难。本研究聚焦于损伤原因及预测因素，以识别有风险的儿童并确定合适的诊断程序。
对2010年至2021年在一家一级儿科创伤中心因脊髓损伤入院的患者进行回顾性病历审查，数据来自荷兰国家创伤登记处。
我们纳入了114例脊髓损伤儿童，其中79.8%年龄在12至17岁。在总体创伤人群中，12至17岁儿童脊髓损伤发生率为10%，6至11岁儿童为2.3%，0至5岁儿童为0.4%。急诊科27.2%的患者存在神经功能缺损，其中14.0%为永久性缺损。12至17岁患者中91.2%存在脊柱骨折，6至11岁患者中为43.8%，0至5岁患者中为71.4%。脊髓损伤儿童的损伤严重度评分（ISS）为23（标准差14），无脊髓损伤儿童为8（标准差9）。
在0至11岁儿童中，与总体创伤人群相比，脊髓损伤非常罕见，且非骨损伤更多。临床医生应将磁共振成像（MRI）作为常规X线检查后的下一步，用于诊断或排除该组儿童的脊髓损伤。在12至17岁的大龄儿童中，脊髓损伤发生率高得多，为10%。虽然脊髓损伤儿童的ISS较高，但ISS低并不排除脊髓损伤。如果发现一处骨折，脊柱其他部位可能存在更多骨折。
