학술논문
Paediatric spine injuries in the thoracic and lumbar spine—results of the German multicentre CHILDSPINE study.
Document Type
Article
Author
Herren, Christian; Jarvers, Jan-Sven; Jung, Matthias K.; Blume, Christian; Meinig, Holger; Ruf, Michael; Weiß, Thomas; Rüther, Hauke; Welk, Thomas; Badke, Andreas; Gonschorek, Oliver; Heyde, Christoph E.; Kandziora, Frank; Knop, Christian; Kobbe, Philipp; Scholz, Matti; Siekmann, Holger; Spiegl, Ulrich; Strohm, Peter; Strüwind, Christoph
Source
Subject
*THORACIC vertebrae
*LUMBAR vertebrae
*ACCIDENTAL falls
*SPINAL injuries
*CHILD patients
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Language
ISSN
0940-6719
Abstract
Background: Paediatric thoracolumbar spine injuries are rare, and meaningful epidemiological data are lacking. Objectives: The aim of this study was to provide epidemiological data for paediatric patients with thoracolumbar spinal trauma in Germany with a view to enhancing future decision-making in relation to the diagnostics and treatment of these patients. Materials and Methods: A retrospective multicentre study includes patients up to 16 years of age who were suffering from thoracolumbar spine injuries who had been treated in six German spine centres between 01/2010 and 12/2016. The clinical database was analysed for patient-specific data, trauma mechanisms, level of injury, and any accompanying injuries. Diagnostic imaging and subsequent treatment were investigated. Patients were divided into three age groups for further evaluation: age group I (0–6 years), age group II (7–9 years) and age group III (10–16 years). Results: A total of 153 children with 345 thoracolumbar spine injuries met the inclusion criteria. The mean age at the time of hospitalization due to the injury was 12.9 (± 3.1) years. Boys were likelier to be affected (1:1.3). In all age groups, falls and traffic accidents were the most common causes of thoracolumbar spine injuries. A total of 95 patients (62.1%) were treated conservatively, while 58 (37.9%) of the children underwent surgical treatment. Minimally invasive procedures were the most chosen procedures. Older children and adolescents were likelier to suffer from higher-grade injuries according to the AOSpine classification. The thoracolumbar junction (T11 to L2) was the most affected level along the thoracolumbar spine (n = 90). Neurological deficits were rarely seen in all age groups. Besides extremity injuries (n = 52, 30.2%), head injuries represented the most common accompanying injuries (n = 53, 30.8%). Regarding spinal injuries, most of the patients showed no evidence of complications during their hospital stay (96.7%). Conclusions: The thoracolumbar junction was more frequently affected in older children and adolescents. The majority of thoracolumbar spinal column injuries were treated conservatively. Nevertheless, 37.9% of hospitalized children had to be treated surgically, and there was an acceptable complication rate for the surgeries that were performed. [ABSTRACT FROM AUTHOR]