title: Spinal injuries in children.
abstract: OBJECTIVE
  Traumatic spinal injury (TSI) is an uncommon source of morbidity and mortality in children. The aim of this study was to describe childhood TSI in a single level 1 urban pediatric trauma center.
  
  
  METHODS
  The authors retrospectively analyzed all children younger than 14 years with TSI, treated at a level I pediatric trauma center between 1991 and 2002 (n = 406, 4% total registry). All children were stratified according to demographics, mechanisms, type and level of injury, radiologic evaluations, associated injuries, and mortality.
  
  
  RESULTS
  The mean age was 9.48 +/- 3.81 years. The most common overall mechanism of injury was motor vehicle crash (MVC; 29%) and ranked highest for infants. Falls ranked highest for ages 2 to 9 years. Sports ranked highest in the 10 to 14 year age group. Paravertebral soft tissue injuries were 68%. The most common injury level was the high cervical spine (O-C4). The incidence of spinal cord injury without radiologic abnormality (SCIWORA) was 6%. Traumatic brain injury (37%) was the most common associated injury. Overall mortality rate was 4% in this urban catchment.
  
  
  CONCLUSIONS
  TSI in children requires a different preventive and therapeutic logarithm compared with that of adults. The potential devastating nature of TSI warrants that the health care team always maintains a high index of suspicion for injury. Future prospective studies are needed to further elucidate injury patterns.
authors.affiliation: Pediatric Division, Department of Neurosurgery; Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Bayram
authors.initials: B
authors.lastname: Cirak
authors.forename: Suzan
authors.initials: S
authors.lastname: Ziegfeld
authors.forename: Vinita Misra
authors.initials: VM
authors.lastname: Knight
authors.forename: David
authors.initials: D
authors.lastname: Chang
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Avellino
authors.forename: Charles N
authors.initials: CN
authors.lastname: Paidas
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D019567:Back Injuries / Q000453:epidemiology / Q000209:etiology; D015142:Baltimore / Q000453:epidemiology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D002391:Catchment Area, Health; D002574:Cervical Vertebrae; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D013904:Thoracic Vertebrae; D014193:Trauma Centers / Q000706:statistics & numerical data; D014505:Urban Population; D014948:Wounds, Gunshot / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology