Cervical Spine Trauma in Children: A Review

Todd Mccall, MD; Dan Fassett, MD; Douglas Brockmeyer, MD


Neurosurg Focus. 2006;20(2):E5 

In This Article

Causes of SCI

Injuries of the cervical spine[19,64] and spinal cord[28,48,78] in children are relatively infrequent compared with their occurrence in adults. Pediatric cases of cervical spine injury account for less than 10% of all such injuries,[50] and approximately 40 to 60% of all pediatric spine injuries occur in the cervical region.[40,41] Besides the ones associated with birth trauma, young children rarely incur fractures below C-2.[40,80] As children become older and their biomechanics more closely approximate those of adults, however, fractures more commonly occur in the lower cervical spine.[40]

Motor vehicle accidents are the most common cause of pediatric cervical injuries, but obstetrical complications, falls, sports, diving accidents, firearms, and child abuse account for many injuries as well.[5,19,53,60,91] As would be expected, the contribution of different mechanisms varies with the patient's age. In neonates, the leading cause of cervical injury is obstetrical complications.[91,96] Spinal cord injuries occur in one of 60,000 births,[100] with the upper cervical region most frequently involved.[59] Cardinal features of birth-related upper cervical SCI include apnea, flaccid quadriplegia, and injuries due to the use of forceps. Unfortunately, neonatal death is common with such injuries.[1,3] Birth-related cervical injuries are usually associated with a breech presentation,[12,15] although they can also occur with cephalic delivery.[87] Cervical injuries in infants and toddlers usually result from falls, motor vehicle accidents, and nonaccidental trauma.[37,38,93] Among children 3 to 10 years of age, falls, bicycle mishaps, and auto-pedestrian accidents account for most injuries,[44,80] and after the age of 10 years, sports and motor vehicle accidents are the biggest culprits.[40,52,53]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.