Pediatric Cervical Spine Trauma: A Narrative Review

Study design: Narrative review.

Objective: To provide an updated overview of pediatric cervical spine trauma.

Summary of background data: Pediatric cervical spine trauma can cause debilitating morbidity and mortality and neurological impairment. The unique anatomic features of the developing cervical spine can predispose children to injuries.

Methods: We reviewed the pediatric cervical spine trauma literature in PubMed and EMBASE.

Results: Pediatric cervical spine injury occurs in 1%-2% of pediatric trauma. The most frequent cause is motor vehicle collisions, with sports-related injuries being more common in older children. Larger head-to-body ratios and tissue elasticity can predispose young children to a greater risk of injury higher in the craniocervical junction and cervical spine. Standardized protocols and classification systems, such as the Pediatric Cervical Spine Clearance Working Group protocol and the AO Spine Injury and Subaxial Cervical Spine Injury Classifications, are valuable in triage as well as for assessing the need for operative versus nonoperative management. In general, operative approaches and principles are similar to those in adults, with modern instrumentation and fusion techniques achieving high rates of successful arthrodesis.

Conclusions: Effective management and treatment of pediatric cervical spine injuries depends on early and accurate diagnosis, a thorough understanding of pediatric spinal anatomy, and a versatile surgical armamentarium.