title: Management of traumatic spinal injuries in children and young adults.
abstract: OBJECTIVE
  Spinal injuries are rarely seen in pediatric patients and therapeutic options are still poorly defined. The present study is aimed to present our experience with a rather large series of children and young adults suffering from traumatic spinal injury.
  
  
  METHODS
  Between 1990 and 2010, 75 consecutive pediatric patients with spinal injuries were treated in our institution. Mean age was 15 years, ranging from 3 months to 21 years. Radiological findings, treatment strategies, and clinical outcome were evaluated retrospectively and compared with literature. Forty (53.3%) patients were treated conservatively and 35 patients (47%) surgically using anterior or posterior approaches. Subgroup analysis was performed depending on age groups, severity of neurological symptoms, and localization.
  
  
  RESULTS
  Main trauma mechanisms were fall in 24 patients (38%) and motor vehicle accidents in 21 patients (28%). Complete neurological deficits were present in 17 individuals (23%) and incomplete in 36 patients (48%). Fractures were most frequently localized at the cervical region (56%) with predilection of the C 5/6 segment. Odontoid fractures were seen in 10 (13%) patients. Fractures of the lumbar and thoracic region were rare. Level of injury or clinical course did not differ between the subgroups (≤15 years versus >15 years).
  
  
  CONCLUSIONS
  Nearly three fourths of all radiologically detected spinal injuries are located at the cervical spine. Complete neurological deficits after trauma was associated with a poor outcome, in particular for patients with injuries of the upper cervical spine. The use of autologous bone graft was associated with favorable long-term results and should be considered as the material of first choice for vertebral body and disc replacement.
authors.affiliation: Department of Neurosurgery, University Hospital of Duisburg-Essen, Essen, Germany, neriman.oezkan@uk-essen.de.
authors.forename: Neriman
authors.initials: N
authors.lastname: Özkan
authors.forename: Karsten
authors.initials: K
authors.lastname: Wrede
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Ardeshiri
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Sariaslan
authors.forename: Klaus Peter
authors.initials: KP
authors.lastname: Stein
authors.forename: Phillip
authors.initials: P
authors.lastname: Dammann
authors.forename: Oliver
authors.initials: O
authors.lastname: Müller
authors.forename: Adrian
authors.initials: A
authors.lastname: Ringelstein
authors.forename: Ulrich
authors.initials: U
authors.lastname: Sure
authors.forename: I Erol
authors.initials: IE
authors.lastname: Sandalcioglu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult