Fractures traverse vertebral body growth plate.Īdapted from Tornetta and Einhorn (2004).Forces dissipated over several adjacent segments.Unique Anatomic Features of Children Age 8 and Younger Up to 30% of traumatic spine injuries in children present as a traumatic myelopathy known as spinal cord injury without radiographic abnormality (SCIWORA). Patients older than 8 years of age typically sustain more injuries below C4 and carry a much lower fatality rate. These factors increase the risk of injury to the levels of C1 and C2.Ĭervical spine injuries occur mainly in the upper cervical spine above C4 in patients 8 years of age or younger which most often involve the occiput, C1, and C2 complex and thus carries increased risk of fatality. Ligaments and joint capsules are more lax, facets are more horizontal, and the vertebral bodies are wedge shaped. Considering the large difference in ratio of head size to body the infant will experience different inertial forces compared to fully matured individuals. The unique anatomic features of children aged 8 years of age or younger are described in table 2. The pediatric cervical spine does not become adult like until about the age of 8 years. Normal Parameters of the Pediatric Cervical Spine Parameter In order to understand the critical aspects of cervical spine injury, it is important to acknowledge the normal parameters of the pediatric cervical spine described in table 1. Children 8 years of age or younger, tend to have more upper cervical injuries when compared with adults because of the anatomy of their bodies. Spinal trauma results from four main mechanisms consisting of hyperflexion, hyperextension, axial loading and lateral rotation. Clearance of the cervical spine is a method that is used to prevent the possibility of quadriplegia and complications of immobilization. It is essential that when one suspects cervical injury, appropriate evaluation and management must be undertaken. Injury to the cervical spine is rare in children and is most often seen in cases of blunt trauma. Click for pdf: Clearing the C-spine Introduction:

Oblique upper cervical spine x ray