Distribution, Clinical Characteristics, and Outcome of Traumatic Spinal Injuries in Pediatric Patients: Experience from a Tertiary Referral Center in South Iran

Abstract

Background: Spine injuries are generally uncommon among children and adolescents; however, the impact on the affected patients can be devastating. The aim of this study was to investigate pediatric spinal injuries presenting to a tertiary trauma center in terms of epidemiology, mechanism, levels of the spinal involvement, and type of fracture, along with the associated morbidity and mortality.
Methods: In this prospective cross-sectional study, we reviewed 58 pediatric cases with traumatic spinal injuries admitted to the first-level emergency department of Namazi hospital, the largest tertiary care referral center in south Iran, over a 3 year time period – from April 2015 to April 2018. Demographic information, clinical records, as well as necessary surgical managements undertaken for the patients were collected. We assessed the outcomes and mortality rate in short-term and long-term follow-ups after 3 years. Data are presented descriptively.
Results: Over the course of 3 years, a total of 58 consecutive pediatric patients with spinal trauma were admitted to the first-level emergency department of our center. The mean age of patients was 6.4 (2 - 17 years old). The male-to-female ratio was almost equal (1:1.2). The majority of patients were pedestrian victims. The multi-level thoracic spine, especially upper and middle thoracic area, was the most frequently injured region (44.4%). A total of 28.6% patients developed post-traumatic neurological deficits.
Conclusions: We concluded that despite the age or mechanism of injury, the most affected areas in the spinal column are upper and middle thoracic spine and in most of our cases there is multi-level fractures in thoracic spine.