title: Unstable Cervical Spinal Injury in Children - Case Report and Review of the Literature.
abstract: Large studies about the management of pediatric patients with unstable flexion-distraction injuries of the midcervical spine are rare. We present the case of a 12-year-old girl who sustained a cervical spinal injury with unilateral facet dislocation and discuss details and problems of diagnostic procedures and treatment in the light of the recent literature. The management and pitfalls of a unilateral facet dislocation in a child are summarized. After initial reposition, a multisegmental instability with neurology developed. Although distraction-flexion cervical spine injuries are common in adults and often occur with concomitant neurological sequelae, they also can occur in the pediatric population. In conclusion, an MRI seems advisable. A treatment of postoperative malalignment with reposition via a halo-fixator cannot be recommended. Repositioning is possible but was lost when the fixator was removed. Comparing the historic and recent literature there is only weak evidence overall, nevertheless a ventral fusion seems to be the treatment option of choice.
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Hamburg, Germany. m.faschingbauer@apschulz.de.|Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Bergedorfer Strasse 10, 21027, Hamburg, Germany. m.faschingbauer@apschulz.de.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Faschingbauer
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Hamburg, Germany.|Department of Trauma and Orthopedic Surgery, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Arndt P
authors.initials: AP
authors.lastname: Schulz
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Hamburg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Seide
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Hamburg, Germany.|Department of Trauma and Orthopedic Surgery, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jürgens
keywords: Cervical spine; Cervical stabilization; Children; Hexapod fixator; Spinal instability; Unilateral facet dislocation