Epidemiology of spinal fractures in children: Cross-sectional study - 12/11/20
, Emmanuelle Ferrero b, Julien Leroux c, Yan Lefevre d, Pierre Journeau e, Rapahël Vialle f, Christophe Glorion g, Philippe Violas h, Antoine Chalopin i, Thierry Odent j, Elie Haddad k, Jérémie Nallet l, Christophe Garin m, Elie Choufani n, Tristan Langlais o, Jérôme Sales de Gauzy athe French Society of Spinal Surgery (SFCR), French Society of Pediatric Orthopedics (SOFOP)p
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Abstract |
Introduction |
Epidemiological studies of fractures of the spine in children are all old, mostly single-centre, with series spanning periods of 5 to 20 years.
Hypothesis |
As lifestyle is constantly changing, notably with an increase in sports activities and improvements in the prevention of road and household accidents, epidemiology has likely changed.
Objective |
To update the description of spinal trauma in children and adolescents compared to the existing literature.
Material and method |
A multicentre cross-sectional study of spinal fracture, dislocation and spinal cord injury without radiological abnormality (SCIWORA) in children was carried out in 15 French university hospital centres, for a period of one year (2016).
Results |
One hundred and sixty-five children were identified: 85 girls, 80 boys; mean age 11 years (range, 10 months–17 years); median, 12 years 6 months. One hundred and fifty-two children (92%) had fracture, 8 (5%) dislocation (including 7 C1-C2 rotary dislocations), and 5 (3%) SCIWORA. Fractures were multiple in 80 cases (49%), contiguous in 73 cases (91%) and non-contiguous in 7 (9%). Locations were cervical in 25 cases (15%), thoracic in 85 (52%), lumbar in 75 and sacral in 4 (2%). Fracture types comprised 234 vertebral compactions (78%), 25 burst fractures (8%), 5 chance fractures (2%), 2 odontoid fractures, and 33 other lesions. Causes comprised fall in 77 cases (47%), sports accidents in 56 (34%), road accidents in 29 (18%), and others in 3. In 52 cases (32%), there was ≥1 associated lesion: appendicular in 35 cases (67%), thoracic or abdominal in 31 (60%), and head in 16 (31%). Twenty-one cases had multiple lesions (40%). Eighteen cases showed neurological involvement (11%) including 5 SCIWORAs. Neurological complications were more frequent before 9 years of age.
Conclusion |
The epidemiology of spine fractures in children has slightly changed. There are now fewer cervical lesions. Causes are less often road accidents and more often sports accidents. Multi-level lesions remain frequent and the rate of neurological complications is around 10%. Compaction fracture is the most common type.
Le texte complet de cet article est disponible en PDF.Keywords : Spinal fracture, Spinal trauma, Children and adolescents, Epidemiology, SCIWORA
Plan
Vol 106 - N° 7
P. 1245-1249 - novembre 2020 Retour au numéro
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