title: Pediatric Cervical Spine Injuries: A Rare But Challenging Entity.
abstract: BACKGROUND
  Injuries to the cervical spine in pediatric patients are uncommon. A missed injury can have devastating consequences in this age group. Because of the lack of routine in diagnosis and management of pediatric cervical spine injuries (PCSI), each of these cases represents a logistic and personal challenge.
  
  
  METHODS
  By means of clinical cases, we demonstrate key points in diagnostics and treatment of pediatric spine injuries. We highlight typical pediatric injury patterns and more adult-like injuries.
  
  
  RESULTS
  The most common cause of injury is blunt trauma. There is an age-related pattern of injuries in pediatric patients. Children under the age of 8 frequently sustain ligamentous injuries in the upper cervical spine. After the age of 8, the biomechanics of the cervical spine are similar to adults, and therefore, bony injuries of the subaxial cervical spine are most likely to occur. Clinical presentation of PCSI is heterogeneous. Younger children can neither interpret nor communicate neurological abnormalities, which make timely and accurate diagnosis difficult. Plain radiographs are often misinterpreted. We find different types of injuries at different locations, because of different biomechanical properties of the immature spine. We outline that initial management is crucial for long-term outcome.
  
  
  CONCLUSIONS
  Knowledge of biomechanical properties and radiographic presentation of the immature spine can improve the awareness for PCSI. Diagnosis and management of pediatric patients after neck trauma can be demanding.
  
  
  METHODS
  Level IV.
authors.affiliation: *Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany †The Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
authors.forename: Florian
authors.initials: F
authors.lastname: Baumann
authors.forename: Toni
authors.initials: T
authors.lastname: Ernstberger
authors.forename: Carsten
authors.initials: C
authors.lastname: Neumann
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: Markus
authors.initials: M
authors.lastname: Loibl
mesh_terms: D000293:Adolescent; D000328:Adult; D019090:Case Management; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008022:Ligaments / Q000293:injuries; D013124:Spinal Injuries / Q000628:therapy*; D016896:Treatment Outcome