Patterns and risks in spinal trauma.
BACKGROUND
Spinal injury in children is rare, and poses many difficulties in management.


OBJECTIVE
To ascertain the prevalence of spinal injury within the paediatric trauma population, and to assess relative risks of spinal injury according to age, conscious level, injury severity score (ISS), and associated injuries.


METHODS
Spine injured children were identified from the UK Trauma Audit & Research Network Database from 1989 to 2000. Relative risks of injury were calculated against the denominator paediatric trauma population.


RESULTS
Of 19 538 on the database, 527 (2.7%) suffered spinal column fracture/dislocation without cord injury and 109 had cord injury (0.56% of all children; 16.5% of spine injured children). Thirty children (0.15% of all children; 4.5% of spine injured children) sustained spinal cord injury without radiological abnormality (SCIWORA). Cord injury and SCIWORA occurred more commonly in children aged < or =8. The risk of spine fracture/dislocation without cord injury was increased with an ISS >25 and with chest injuries. The risk of cord injury was increased with reduced GCS, head injury, and chest injury.


CONCLUSIONS
Spinal cord injury and SCIWORA occur more frequently in young children. Multiple injuries and chest injuries increase the risk of fracture/dislocation and of cord injury. Reduced GCS and head injuries increase the risk of cord injury.
Salford Royal Hospitals NHS Trust, UK. bruce.martin@virgin.net
B W
BW
Martin
E
E
Dykes
F E
FE
Lecky
D017677:Age Distribution; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000453:epidemiology / Q000209:etiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000209:etiology; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D013124:Spinal Injuries / Q000453:epidemiology* / Q000209:etiology; D013898:Thoracic Injuries / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology