title: Traumatic spinal injuries in children at a single level 1 pediatric trauma centre: report of a 23-year experience.
abstract: BACKGROUND
  With a reported incidence of up to 10% compared to all spinal trauma, spinal injuries in children are less common than in adults. Children can have spine fractures with or without myelopathy, or spinal cord injuries without radiological abnormalities (SCIWORA).
  
  
  METHODS
  We retrospectively reviewed the cases of children with spinal injuries treated at a level 1 pediatric trauma centre between 1990 and 2013.
  
  
  RESULTS
  A total of 275 children were treated during the study period. The mean age at admission was 12 ± 4.5 years, and the male:female ratio was 1.4:1. Spinal injuries were more common in children of ages 12-16 years, with most injuries among ages 15-16 years. The top 3 mechanisms of spinal injury were motor vehicle-related trauma (53%), sports (28%) and falls (13%). Myelopathy occurred in 12% and SCIWORA occurred in 6%. The most common spine levels injured were L2-sacrum, followed by O-C2. Associated injuries, including head injuries (29%), and fractures/dislocations (27%) occurred in 55% of children. Overall mortality was 3%. Surgical intervention was required in 14%.
  
  
  CONCLUSIONS
  The creation of a pediatric spinal injury database using this 23-year retrospective review helped identify important clinical concepts; we found that active adolescent boys had the highest risk of spine injury, that noncontiguous spine injuries occured at a rate higher than reported previously and that nonaccidental spine injuries in children are underreported. Our findings also emphasize the importance of maintaining a higher index of suspicion with trauma patients with multiple injuries and of conducting detailed clinical and radiographic examinations of the entire spine in children with a known spinal injury.
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Christopher
authors.initials: C
authors.lastname: Kim
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Michael
authors.initials: M
authors.lastname: Vassilyadi
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Jason K
authors.initials: JK
authors.lastname: Forbes
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Nicholas W P
authors.initials: NW
authors.lastname: Moroz
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Alexandra
authors.initials: A
authors.lastname: Camacho
authors.affiliation: From the Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ont. (Kim, Forbes, N. Moroz, Camacho); the Division of Neurosurgery, Children's Hospital of Eastern Ontario, Department of Surgery, University of Ottawa, Ottawa, Ont. (Vassilyadi); and the Division of Orthopedic Surgery, Shriners Hospitals for Children, Honolulu, HI (P. Moroz).
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Moroz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D013124:Spinal Injuries / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D014193:Trauma Centers / Q000706:statistics & numerical data*