CERVICAL SPINAL-CORD INJURY IN CHILDREN

We examined 19 children under 10 years of age with cervical spinal cord injury using clinical records and radiographs. The children were divided into two groups: Eight had immediate and complete spinal cord injury, and 11 had incomplete or partial spinal cord injury. Those with complete spinal cord injury were injured in motor vehicle accidents with a proximal spinal cord injury. Eighty-eight percent had cervical spine fractures/instability with a distraction pattern of injury. Half had associated trauma. The mortality rate was 25%, and those who survived showed no neurologic improvement. Most of the children with partial spinal cord injury were injured at birth. Many had no radiographic evidence of cervical fracture. One-quarter had associated trauma. The neurologic improvement averaged 1.9 Frankel grades. Half of both groups required posterior cervical fusion, and there was a significant complication rate. Eighty-eight percent developed scoliosis, and 71% developed hip subluxation.