Pediatric neck injuries

A clinical study

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✓ This review of pediatric neck injuries includes patients admitted to Children's Hospital of Columbus, Ohio, during the period 1969 to 1979. The 122 patients with neck injuries constituted 1.4% of the total neurosurgical admissions during this time. Forty-eight patients had cervical strains; 74 had involvement of the spinal column; and 27 had neurological deficits. The injuries reached their peak incidence during the summer months, with motor-vehicle accidents accounting for 31%, diving injuries and falls from a height 20% each, football injuries 8%, other sports 11%, and miscellaneous 10%.

There is a clear division of patients into a group aged 8 years or less with exclusively upper cervical injuries, and an older group with pancervical injuries. In the younger children, the injuries involved soft tissue (subluxation was seen more frequently than fracture), and tended to occur through subchondral growth plates, with a more reliable union than similar bone injuries. In the older children, the pattern and etiology of injury are the same as in adults. The entire cervical axis is at risk, and there is a tendency to fracture bone rather than cartilaginous structures.

Article Information

Address reprint requests to: Carole A. Miller, M.D., University Hospital, N-911, 410 West 10th Avenue, Columbus, Ohio 43210.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Relationship between age and pathology, showing the total group of pediatric neck injuries (left), patients with cervical strains with plain x-ray findings (center), and patients with spinal column injury (right).

  • View in gallery

    Distribution of injuries by calendar month: all pediatric neck injuries (A); cervical strains (B); bone and ligament injuries (C); and injuries resulting in neurological deficit (D).

  • View in gallery

    Relationship between patients' age and the levels of bone injury (solid lines) and neurological deficit (broken lines).

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