Management of cervical spine trauma in children

Cervical spine injuries in children are rare but can have devastating neurological consequences, impacting the child and their family. Therefore, excellent management is crucial, from initial evaluation to definitive treatment and rehabilitation. Children's spines have different properties than adults, like greater elasticity, which can lead to injuries without obvious bone damage on X-rays or CT scans. This is known as SCIWORA (spinal cord injury without radiological abnormality). Initial management follows Advanced Trauma Life Support (ATLS) principles, emphasizing immobilization in a neutral position. However, rigid cervical collars may not fit children well, so a comfortable position with manual stabilization is often preferred.

• 1
  Upper cervical spine injuries are more common in younger children (≤ 8 years), while lower cervical spine injuries are more prevalent in older children (> 8 years).
• 2
  Children are more likely to experience incomplete spinal cord injuries compared to adults. Complete spinal cord injury often leads to irreversible and devastating consequences.
• 3
  MRI is the preferred imaging modality for assessing ligamentous damage, especially in obtunded or non-verbal children, and when the cervical spine cannot be cleared within 72 hours.