Schwarz N, Ohner T, Schwarz A F, Gerschpacher M, Meznik A
Unfallkrankenhaus Wien-Meidling.
Unfallchirurg. 1993 May;96(5):235-41.
Ligamentous and osseous injuries of the cervical spine during growth are extremely rare and therapeutic principles for such lesions are ill-defined. In order to help solve some diagnostic and therapeutic problems a retrospective study of 30 children was carried out. There were 5 discoligamentous injuries, 5 fractures of the atlas, 1 fracture of the arcus C2, 8 fractures of the odontoid, and 11 vertebral body compression fractures. The injuries were caused by motor vehicle accident in 9, by diving into shallow water in 7, by falling from a height in 7, by a sports accident in 6, and by a direct trauma in 1 patient. Four children died, three of them due to concomitant brain injury. Two patients suffered permanent neurologic disability due to spinal cord trauma. Five patients underwent an operation. Conservative therapy of flexion-compression fractures of the vertebral bodies caused kyphotic deformity. Ventral interbody fusion in two patients had excellent long-term results. All odontoid fractures were treated by applying a plaster cast and healed promptly. Diagnostic problems were mainly caused by the hypermobility of the upper cervical spine.
生长期间颈椎的韧带和骨性损伤极为罕见，此类损伤的治疗原则尚不明确。为了帮助解决一些诊断和治疗问题，对30名儿童进行了回顾性研究。其中有5例韧带损伤、5例寰椎骨折、1例C2椎弓骨折、8例齿状突骨折和11例椎体压缩骨折。损伤原因包括：9例因机动车事故、7例因跳入浅水区、7例因高处坠落、6例因体育事故以及1例因直接创伤。4名儿童死亡，其中3例死于合并的脑损伤。2例患者因脊髓损伤而出现永久性神经功能残疾。5例患者接受了手术。椎体屈曲压缩骨折的保守治疗导致了后凸畸形。2例患者接受的前路椎间融合术取得了良好的长期效果。所有齿状突骨折均采用石膏固定治疗，愈合迅速。诊断问题主要是由上颈椎的过度活动引起的。
