Spinal fracture through the neurocentral synchondrosis in battered children: a report of three cases.
METHODS
Retrospective case series.


OBJECTIVE
To report 3 cases of unusual spinal fracture through the neurocentral synchondrosis.


BACKGROUND
Traumatic lesions of the spine or spinal cord due to physical abuse are rare. We report 3 cases of vertebral fractures involving the neurocentral synchondrosis in battered children.


METHODS
The medical data of the 3 cases were retrospectively reviewed. We discuss the pathomechanism and treatment strategies.


RESULTS
In 2 cases, the vertebral body was displaced anteriorly and, in 1 case, posteriorly, all without neurologic compromise. The lateral radiographs showed vertebral displacement, but the diagnosis could be suspected on frontal views because of interpedicular distance widening. Treatment was nonoperative with bracing in 2 cases. In the third case, a posterior epiphysiodesis was done to avoid development of progressive kyphosis of the injured spine. One child treated nonoperatively died from other traumatic lesions associated with the physical abuse. In the 2 other cases, outcome was good with a well-balanced spine in 1 case and a moderate, well-tolerated kyphosis in the other case.


CONCLUSIONS
Such spinal lesions are rare but could be conservatively treated in case of anterior vertebral displacement without vertebral endplate impairment. A posterior displacement of vertebral body could be responsible for a neurologic compromise.
Vialle
Raphaël
R
Department of Paediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris VI, Paris, France. ravialle@noos.fr
Mary
Pierre
P
Schmider
Laurent
L
le Pointe
Hubert Ducou
HD
Damsin
Jean-Paul
JP
Filipe
Georges
G