title: Paediatric cervical spine injures. Nineteen years experience of a single centre.
abstract: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years.
  
  
  
  Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied.
  
  
  
  Seventy-five cases of C-spine injuries (nine SCIWORA) were identified. Group A included 23 patients and group B 52. In group A, skeletal injuries at the upper C-spine were more common than injuries at the lower C-spine, whereas in group B, injuries of the lower C-spine were more frequent (p = 0.035). Motor vehicle accidents were the main cause of injury (44 %); 25.3 % of patients were surgically treated. Thirty-nine patients presented neurologic deficits, 16 of which improved. The overall mortality rate was 18.7 % and significantly higher in patients with neurological damages (p < 0.001) CONCLUSIONS: This study revealed a low incidence of cervical spine injuries in the paediatric population. As in previous reports younger children mainly sustained injuries at the upper C-spine, higher incidence of spinal injuries, and higher risk of death than older children.
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal. manuelrisilva@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ribeiro da Silva
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.|Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Centro Hospitalar de S. João, EPE, Porto, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Linhares
authors.affiliation: Orthopaedic Department, Hospital da Prelada, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Cacho Rodrigues
authors.affiliation: Orthopaedic Department, Centro Hospitalar de Entre o Douro e Vouga, EPE, Santa Maria da Feira, Portugal.
authors.forename: Eurico Lisboa
authors.initials: EL
authors.lastname: Monteiro
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Santos Carvalho
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Negrão
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Rui Peixoto
authors.initials: RP
authors.lastname: Pinto
authors.affiliation: Orthopaedic Department, Centro Hospitalar de São João, EPE, Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Neves
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D013124:Spinal Injuries / Q000453:epidemiology*; D014193:Trauma Centers / Q000706:statistics & numerical data
keywords: Cervical spine; Cervical vertebrae; Injuries; Pediatrics