Traumatic Spinal Cord Injuries in the Pediatric Population: A Retrospective Study

Introduction: Spine Trauma has been reported in the pediatric population and is associated with increased long-term morbidity. In this study, we aim to review a 13-year institutional experience of spine trauma comprising cervical and thoracolumbar cases and compare it with data from the literature.

Methods: Patient records were retrospectively reviewed from a single-center trauma hospital from 2011 to 2024 after obtaining institutional review board and ethical approval. Inclusion criteria were: (1) pediatric patients under 18 years (2) with a history of spine trauma. We collected demographics data in addition to outcome endpoints such as the ASIA score, mortality, permanent neurological deficit, and requirement of admission to intensive care unit (ICU). In addition, we explored possible risk factors that might be associated with increased mortality or ICU admissions

Results: There were 275 children with spine trauma. The mean age was 11.9 years, and mean follow-up was 50.5 months. Concurrent traumatic brain injury was present in 19 patients (6.9%). Ninety-four patients (34.2%) required ICU admission with 6 mortalities (2.1%). Eight patients (2.6%) had long-term permanent neurological deficit. Motor vehicle collision (40.7%) was the most reported injury modality followed by fall from height (28%). Most of our patients (189 children) were ASIA E (68.1%) on admission. In addition, 28 patients (10.3%) had improved ASIA score at follow-up. A total of 64 patients (23.3%) required surgery, with 11 patients (4%) through an anterior approach and 48 patients (17.5%) through a posterior approach. At median follow-up of 25 months, the mean ASIA score improvement was 2.6 in the surgical cohort.

Conclusion : Spinal trauma is prevalent in the pediatric population with potential to cause permanent neurological deficit. Motor vehicle collisions were the most likely cause of injury in our cohort. Children with spinal cord injury who needed surgery for reduction and fixation often improved.