소아와 청소년의 외상에 의한 경추골절 및 외상성 탈구

Abstract

Injury of the cervical spine in children and adolescents is relatively uncommon. And information concerning this problem is sparse. The purpose of this particular study was to identify the incidence. Level, type of injury, and the incidence of neural involvement in children and adolescents and to find the different injury pattern between the two age groups. A retrospectively analysis of the records of 446 patients who were seen at Severance Hospital between March, 1974, and Novemeber, 1993 under the diagnosis of acute injury on the cervical spine was performed. Among them, 21 cases were under 15 years of age. (4.7%) The patients were classified into two age group, children and adolescents. The cause of injury, level and patterns of injury, age distribution, results of treatment and neurologic injury were compared between these two groups. The results of the study were as follows: 1. Among the 18 cases, there were 13 boys(72%) and 5 girls(28%). The mean age was 8.4 years. And 13 cases(72%) were between 4 to 10 years of age. 2. The most common cause of injury was fall from the height(50%) in children and automobile accident(50%) in adolescents. 3. Injuries to upper cervical spine(occiput to C3) were more common in children (85%). In adolescents, lower cervical spinal injuries(C4 to C7) were more common (75%). 4. In the present study, atlantoaxial subluxations were more common in both age group(38%). 5. The most common associated injury was head injury, (6 cases, 33%). Neurologic complications were found in 2 cases and all of the cases were recovered. The prognosis of the spinal cord injury in children and adolescents was good. 6. All but one case were treated conservatively and the result was satisfactory. In conclusion, there was no significant difference between the children and adolescents. The cervical spine injuries in children and adolescents were rare and ligamentous injuries were more common in both age group and the results were satisfactory by conservative treatment.