Cervical spine injury in children and adolescents is rare but presents a diagnostic challenge. Anatomic and radiographic differences between the pediatric and adult spine must be understood in order to differentiate injury from normal variant. Conditions predominantly seen in childhood, such as spinal cord injury without radiologic abnormality (SCIWORA), need to be aggressively sought. A formal policy for cervical spine clearance in children can help avoid unnecessary treatment and missed injuries. Injuries can be divided into upper cervical injury (cervical vascular injury, occipital condyle fractures, atlanto-occipital injuries, odontoid fractures, atlantoaxial rotary subluxation, fractures of C1 and C2) as well as subaxial injuries (fractures and dislocations). As in the adult, stable injuries are treated with immobilization, while unstable injuries require stabilization. An understanding of the relevant anatomy and surgical approaches to the treatment of these injuries in the growing child is crucial to provide effective treatment in this population.
- Pediatric cervical spine
- Atlantoaxial rotatory subluxation
- Pediatric cervical spine clearance
- Pediatric cervical spine injury
- Pediatric cervical spine anatomy
This is a preview of subscription content, access via your institution.
Jones TM, Anderson PA, Noonan KJ. Pediatric cervical spine trauma. J Am Acad Orthop Surg. 2011;19:600–11.
Vanderhave K, Chiravuri S, Caird M, Farley F, Graziano G, Hensinger R, Patel R. Cervical spine trauma in children and adults: perioperative vonsiderations. J Am Acad Orthop Surg. 2011;19:319–27.
Mohseni S, Talving P, Branco BC, Chan LS, Lustenberger T, Inaba K, Bass M, Demetriades D. Effect of ages on cervical spine injury in pediatric population: a National Trauma Data Bank review. J Pediatr Surg. 2011;46(9):1771–6.
Eubanks J, Gilmore A, Bess S, Cooperman D. Clearing the pediatric cervical spine following injury. J Am Acad Orthop Surg. 2006;14:552–64.
Rush JK, Kelly DM, Astur N, Creek A, Dawkins R, Younas S, et al. Associated injuries in children and adolescents with spinal trauma. J Pediatr Orthop. 2013;33(4):393–7.
Kokosa E, Keller M, Rallo M, Weber T. Characteristics of pediatric cervical spine injuries. J Pediatr Surg. 2001;36(1):100–5.
McCall T, Fassett D, Brockmeyer D. Cervical spine trauma in children: a review. Neurosurg Focus. 2006;20(2):1–8.
Kreykes NS, Letton RW Jr. Current issues in the diagnosis of pediatric cervical spine injury. Semin Pediatr Surg. 2010;19:257–64.
Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325–43.
Launay F, Leet AL, Sponseller PD. Pediatric spinal cord injury without radiographic abnormality: a meta-analysis. Clin Orthop Relat Res. 2005;433:166–70.
Cirak B, Ziegfeld S, Knight VM, Chang D, Avellino AM, Paidas CN. Spinal injuries in children. J Pediatr Surg. 2004;39(4):607–12.
Carreon LY, Glassman SD, Campbell MJ. Pediatric spine fractures: a review of 137 hospital admissions. J Spinal Disord Tech. 2004;17(6):477–82.
Leonard M, Sproule J, McCormack D. Paediatric spinal trauma and associated injuries. Injury. 2007;38:188–93.
Asher MA, Jacobs RR. Pediatric thoracolumbar spine trauma. In: Bradford DS, Hensinger RN, editors. The pediatric spine. New York: Thieme; 1985. p. 105–17.
Crawford AH. Operative treatment of spine fractures in children. Orthop Clin North Am. 1990;21(2):325–39.
Lee JH, Sung IY, Kang JY, Park SR. Characteristics of pediatric-onset spinal cord injury. Pediatr Int. 2009;51(2):254–7.
DeVivo MJ, Vogel LC. Epidemiology of spinal cord injury in children and adolescents. J Spinal Cord Med. 2004;27:S4–10.
Kewalramani LS, Tori JA. Spinal cord trauma in children. Neurologic patterns, radiologic features, and pathomechanics of injury. Spine (Phila Pa 1976). 1980;5(1):11–8.
Ruge JR, Sinson GP, McLone DG, Cerullo LJ. Pediatric spinal injury: the very young. J Neurosurg. 1988;68(1):25–30.
Puisto V, Kaarianen S, Impinen A, Parkkila T, Vartiainen E, Jalanko T, et al. Incidence of spinal and spinal cord injuries and their surgical treatment in children and adolescents: a population-based study. Spine (Phila Pa 1976). 2010;35(1):104–7.
Vitale MG, Goss JM, Matsumoto H, Roye DP Jr. Epidemiology of pediatric spinal cord injury in the United States: years 1997 and 2000. J Pediatr Orthop. 2006;26:745–9.
Augutis M, Levi R. Pediatric spinal cord injury in Sweden: incidence, etiology, and outcome. Spinal Cord. 2003;41:328–36.
Jones L. Birth trauma and the cervical spine. Arch Dis Child. 1970;15(1):55–64.
Podolsky S, Baraff LJ, Simon RR, Hoffman JR, Larmon B, Ablon W. Efficacy of cervical spine immobilization methods. J Trauma. 1983;23:461–5.
Buhs C, Cullen M, Klein M, Farmer D. The pediatric trauma C-spine: is the ‘odontoid’ view necessary? J Pediatr Surg. 2000;35(6):994–7.
Hernandez JA, Chupik C, Swischuk LE. Cervical spine trauma in children under 5 years: productivity of CT. Emerg Radiol. 2004;10(4):176–8.
Carlan D, Bradbury T, Green N, et al. The efficacy of helical CT versus conventional radiography of the cervical spine in pediatric trauma. Abstract. Pediatric Orthopedic Society of North America Annual meeting. Albuquerque; 2008.
Keenan HT, Hollingshead MC, Chung CJ, Ziglar MK. Using CT of the cervical spine for early evaluation of pediatric patients with head trauma. Am J Radiol. 2001;177:1405–9.
Brockmeyer DL, Ragel BT, Kestle JR. The pediatric cervical spine instability study. A pilot study assessing the prognostic value of four imaging modalities in clearing the cervical spine with severe traumatic injuries. Childs Nerv Syst. 2012;28(5):699–705.
Henry M, Scarlata K, Riesenburger RI, Kryzanski J, Rideout L, Samdani A, et al. Utility of STIR MRI in pediatric cervical spine clearance after trauma. J Neurosurg Pediatr. 2013;12(1):1333–8.
Frank J, Lim C, Flynn J, Dormans J. The efficacy of magnetic resonance imaging in pediatric cervical spine clearance. Spine. 2002;27(11):1176–9.
Hutchings L, Willett K. Cervical spine clearance in pediatric trauma: a review of current literature. J Trauma. 2009;67(4):687–91.
Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343(2):94–9.
Pieretti-Vanmarcke R, Velmahos GC, Nance ML, Islam S, Falcone RA Jr, Wales PW, et al. Clinical clearance of the cervical spine in blunt trauma patients younger than 3 years: a multi-center study of the American Association for the Surgery of Trauma. J Trauma. 2009;67(3):543–9.
Lee SL, Sena M, Greenholz SK, Fledderman M. A multidisciplinary approach to the development of a cervical spine clearance protocol: process, rationale, and initial results. J Pediatr Surg. 2003;38(3):358–62.
Cook BS, Fanta K, Schweer L. Pediatric cervical spine clearance: implications for nursing practice. J Emerg Nurs. 2003;29(4):1–4.
Tolhurst SR, Vanderhave KL, Caird MS, Garton HL, Graziano GP, Maher CO, et al. Cervical arterial injury after blunt trauma in children: characterization and advanced imaging. J Pediatr Orthop. 2013;33(1):37–42.
Kapapa T, Tschan CA, Konig K, Schlesinger A, Haubitz B, Becker H, et al. Fracture of the occipital condyle caused by minor trauma in child. J Pediatr Surg. 2006;41(10):1774–6.
Momjian S, Dehdashti AR, Kehrli P, May D, Rilliet B. Occipital condyle fractures in children. Case report and review of the literature. Pediatr Neurosurg. 2003;38(5):265–70.
Strehle EM, Tolinov V. Occipital condylar fractures in children: rare or underdiagnosed? Dentomaxillofac Radiol. 2012;41(2):175–6.
Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine (Phila Pa 1976). 1988;13(7):731–6.
Tuli S, Tator CH, Fehlings MG, Mackay M. Occipital condyle fractures. Neurosurgery. 1997;41(2):368–76; discussion 376–7.
Kenter K, Worley G, Griffin T, Fitch RD. Pediatric traumatic atlanto-occipital dislocation: five cases and a review. J Pediatr Orthop. 2001;21(5):585–9.
Steinmetz MP, Lechner RM, Anderson JS. Atlantooccipital dislocation in children: presentation, diagnosis, and management. Neurosurg Focus. 2003;14(2):ecp1.
Kaufman RA, Carroll CD, Buncher CR. Atlantooccipital junction: standards for measurement in normal children. AJNR Am J Neuroradiol. 1987;8(6):995–9.
Kaufman RA, Dunbar JS, Botsford JA, McLaurin RL. Traumatic longitudinal atlanto-occipital distraction injuries in children. AJNR Am J Neuroradiol. 1982;3(4):415–9.
Lee C, Woodring JH, Goldstein SJ, Daniel TL, Young AB, Tibbs PA. Evaluation of traumatic atlantooccipital dislocations. AJNR Am J Neuroradiol. 1987;8(1):19–26.
Powers B, Miller MD, Kramer RS, Martinez S, Gehweiler JA Jr. Traumatic anterior atlanto-occipital dislocation. Neurosurgery. 1979;4(1):12–7.
Sun PP, Poffenbarger GJ, Durham S, Zimmerman RA. Spectrum of ccipitoatlantoaxial injury in young children. J Neurosurg. 2000;93(1 Suppl):28–39.
Wholey MH, Bruwer AJ, Baker HL Jr. The lateral roentgenogram of the neck; with comments on the atlanto-odontoid-basion relationship. Radiology. 1958;71(3):350–6.
Pang D, Nemzek WR, Zovickian J. Atlanto-occipital dislocation: part 1--normal occipital condyle-C1 interval in 89 children. Neurosurgery. 2007;61(3):514–21; discussion 521.
Pang D, Nemzek WR, Zovickian J. Atlanto-occipital dislocation–part 2: the clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children. Neurosurgery. 2007;61(5):995–1015; discussion 1015.
Gluncic V, Turner M, Kranzler L, Frim D. Timely recognition of traumatic atlanto-occipital dislocation in a child based on occipital condyle-C1 interval analysis: excellent neurological recovery. J Neurosurg Pediatr. 2010;5(5):465–9.
Lustrin ES, Karakas SP, Ortiz AO, Cinnamon J, Castillo M, Vaheesan K, et al. Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics. 2003;23(3):539–60.
Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, et al. The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst. 2005;21(2):122–7.
Marlin AE, Williams GR, Lee JF. Jefferson fractures in children. Case report. J Neurosurg. 1983;58(2):277–9.
McGrory BJ, Klassen RA, Chao EY, Staeheli JW, Weaver AL. Acute fractures and dislocations of the cervical spine in children and adolescents. J Bone Joint Surg Am. 1993;75(7):988–95.
Ames CP, Acosta F, Nottmeier E. Novel treatment of basilar invagination resulting from an untreated C-1 fracture associated with transverse ligament avulsion. Case report and description of surgical technique. J Neurosurg Spine. 2005;2(1):83–7.
Copley LA, Dormans JP. Cervical spine disorders in infants and children. J Am Acad Orthop Surg. 1998;6(4):204–14.
Khanna G, El-Khoury GY. Imaging of cervical spine injuries of childhood. Skelet Radiol. 2007;36(6):477–94.
Fassett DR, McCall T, Brockmeyer DL. Odontoid synchondrosis fractures in children. Neurosurg Focus. 2006;20(2):E7.
Odent T, Langlais J, Glorion C, Kassis B, Bataille J, Pouliquen JC. Fractures of the odontoid process: a report of 15 cases in children younger than 6 years. J Pediatr Orthop. 1999;19(1):51–4.
Hosalkar HS, Greenbaum JN, Flynn JM, Cameron DB, Dormans JP, Drummond DS. Fractures of the odontoid in children with an open basilar synchondrosis. J Bone Joint Surg Br. 2009;91(6):789–96.
Fulkerson DH, Hwang SW, Patel AJ, Jea A. Open reduction and internal fixation for angulated, unstable odontoid synchondrosis fractures in children: a safe alternative to halo fixation? J Neurosurg Pediatr. 2012;9(1):35–41.
Choit RL, Jamieson DH, Reilly CW. Os odontoideum: a significant radiographic finding. Pediatr Radiol. 2005;35(8):803–7.
Fielding JW, Hensinger RN, Hawkins RJ. Os odontoideum. J Bone Joint Surg Am. 1980;62(3):376–83.
Anonymous. Os odontoideum. Neurosurgery. 2002;50(3 Suppl):S148–55.
McGoldrick JM, Marx JA. Traumatic central cord syndrome in a patient with Os odontoideum. Ann Emerg Med. 1989;18(12):1358–61.
Dempster AG, Heap SW. Fatal high cervical spinal cord injury in an automobile accident complicating os odontoideum. Am J Forensic Med Pathol. 1990;11(3):252–6.
Sasaki H, Itoh T, Takei H, Hayashi M. Os odontoideum with cerebellar infarction: a case report. Spine (Phila Pa 1976). 2000;25(9):1178–81.
Wang J, Vokshoor A, Kim S, Elton S, Kosnik E, Bartkowski H. Pediatric atlantoaxial instability: management with screw fixation. Pediatr Neurosurg. 1999;30(2):70–8.
Gluf WM, Brockmeyer DL. Atlantoaxial transarticular screw fixation: a review of surgical indications, fusion rate, complications, and lessons learned in 67 pediatric patients. J Neurosurg Spine. 2005;2(2):164–9.
Reilly CW, Choit RL. Transarticular screws in the management of C1-C2 instability in children. J Pediatr Orthop. 2006;26(5):582–8.
Heuer GG, Hardesty DA, Bhowmick DA, Bailey R, Magge SN, Storm PB. Treatment of pediatric atlantoaxial instability with traditional and modified Goel-Harms fusion constructs. Eur Spine J. 2009;18(6):884–92.
Kleinman PK, Shelton YA. Hangman’s fracture in an abused infant: imaging features. Pediatr Radiol. 1997;27(9):776–7.
McGrory BE, Fenichel GM. Hangman’s fracture subsequent to shaking in an infant. Ann Neurol. 1977;2(1):82.
Ranjith RK, Mullett JH, Burke TE. Hangman’s fracture caused by suspected child abuse. A case report. J Pediatr Orthop B. 2002;11(4):329–32.
Ruff SJ, Taylor TK. Hangman’s fracture in an infant. J Bone Joint Surg Br. 1986;68(5):702–3.
Williams JP 3rd, Baker DH, Miller WA. CT appearance of congenital defect resembling the Hangman’s fracture. Pediatr Radiol. 1999;29(7):549–50.
van Rijn RR, Kool DR, de Witt Hamer PC, Majoie CB. An abused five-month-old girl: hangman’s fracture or congenital arch defect? J Emerg Med. 2005;29(1):61–5.
Pizzutillo PD, Rocha EF, D’Astous J, Kling TF Jr, McCarthy RE. Bilateral fracture of the pedicle of the second cervical vertebra in the young child. J Bone Joint Surg Am. 1986;68(6):892–6.
Fielding JW, Hawkins RJ. Atlanto-axial rotatory fixation. Fixed rotatory subluxation of the atlanto-axial joint. J Bone Joint Surg Am. 1977;59(1):37–44.
Phillips WA, Hensinger RN. The management of rotatory atlanto-axial subluxation in children. J Bone Joint Surg Am. 1989;71(5):664–8.
Pang D, Li V. Atlantoaxial rotatory fixation: part 1–biomechanics of normal rotation at the atlantoaxial joint in children. Neurosurgery. 2004;55(3):614–25; discussion 625–6.
Pang D, Li V. Atlantoaxial rotatory fixation: part 2–new diagnostic paradigm and a new classification based on motion analysis using computed tomographic imaging. Neurosurgery. 2005;57(5):941–53; discussion 941–53.
Pang D, Li V. Atlantoaxial rotatory fixation: part 3--a prospective study of the clinical manifestation, diagnosis, management, and outcome of children with alantoaxial rotatory fixation. Neurosurgery. 2005;57(5):954–72; discussion 954–72.
Subach BR, McLaughlin MR, Albright AL, Pollack IF. Current management of pediatric atlantoaxial rotatory subluxation. Spine (Phila Pa 1976). 1998;23(20):2174–9.
Lee SC, Lui TN, Lee ST. Atlantoaxial rotatory subluxation in skeletally immature patients. Br J Neurosurg. 2002;16(2):154–7.
Henrys P, Lyne ED, Lifton C, Salciccioli G. Clinical review of cervical spine injuries in children. Clin Orthop Relat Res. 1977;129:172–6.
McPhee B. Spinal fractures and dislocations in children and adolescents. Spine (Phila Pa 1976). 1981;6:533–7.
Pennecot GF, Leonard P, Peyrot Des Gachons S, Hardy JR, Pouliquen JC. Traumatic ligamentous instability of the cervical spine in children. J Pediatr Orthop. 1984;4:339–45.
Evans DL, Bethem D. Cervical spine injuries in children. J Pediatr Orthop. 1989;9:563–8.
Birney TJ, Hanley EN. Traumatic cervical spine injuries in childhood and adolescence. Spine (Phila Pa 1976). 1989;14:277–82.
Osenbach RK, Menezes AH. Pediatric spinal cord and vertebral column injury. Neurosurgery. 1992;30:385–90.
McGrory BJ, Klassen RA, Chao EYS, Staeheli JW, Weaver AL. Acute fractures and dislocations of the cervical spine in children and adolescents. J Bone Joint Surg Am. 1993;75:988–95.
Nitecki S, Moir CR. Predictive factors of the outcome of traumatic cervical spine fractures in children. J Pediatr Surg. 1994;29:1409–11.
Finch GE, Barnes MJ. Major cervical spine injuries in children and adolescents. J Pediatr Orthop. 1998;18:811–4.
Eleraky MA, Theodore N, Adams M, Rekate HL, Sonntag V. Pediatric cervical spine injuries: report of 102 cases and review of the literature. J Neurosurg (Spine 1). 2000;92:12–7.
Patrick DA, Bensard DD, Moore EE, Calkins CM, Karrer FM. Cervical spine trauma in the injured child: a tragic injury with potential for salvageable functional outcome. J Pediatr Surg. 2000;35:1571–5.
Patel JC, Tepas JJ, Mollitt DL, Pieper P. Pediatric cervical spine injuries: defining the disease. J Pediatr Surg. 2001;36:373–6.
Brown RL, Brunn MA, Garcia VF. Cervical spine injuries in children: a review of 103 patients treated consecutively at a level I pediatric trauma center. J Pediatr Surg. 2001;36:1107–14.
Viccellio P, Simon H, Pressman BD, Shah MN, Mower WR, Hoffman JR. A prospective study of cervical spine injury in children. Pediatrics. 2001;108:1–6.
Bilstron LE, Brown J. Pediatric spinal injury type and severity are age and mechanism dependent. Spine (Phila Pa 1976). 2007;32:2339–47.
Dogan S, Abbasi SS, Theodore N, Horns E, Rekate HL, Sonntag VKH. Pediatric subaxial cervical spine injuries: origins, management, and outcome in 51 patients. Neurosurg Focus. 2006;20:1–7.
Allen BL, Ferguson RL, Lehmann TR, O’Brien RP. A mechanistic classification of closed indirect fractures and dislocations of the lower cervical spine. Spine (Phila Pa 1976). 1982;7:1–27.
Vaccaro AR, Hulbert RJ, Patel AA, Fisher C, Dvorak M, Lehman RA Jr, et al. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 2007;32(2):2365–74.
Hall RDM. Clay-shoveler’s fracture. J Bone Joint Surg Am. 1940;22:63–75.
Lovell WW, Winter RB, Morrissy RT, et al. Lovell and Winter’s pediatric orthopaedics. 6th ed. Philadelphia: Lippincott, Williams and Wilkins; 2006. p. xi, 1545, I-42.
Bailey DK. The normal cervical spine in infants and children. Radiology. 1952;59:712–9.
Yamaguchi KT, Myung KS, Alonso MA, Skaggs DL. Clay-shoveler’s fracture equivalent in children. Spine (Phila Pa 1976). 2012;37:E1672–5.
Matar LD, Helms CA, Richardson WJ. Spinolaminar breach: an important sign in cervical spinous process fractures. Skelet Radiol. 2000;29:75–80.
Hill SA, Miller CA, Kosnik EJ, Hunt WE. Pediatric neck injuries: a clinical study. J Neurosurg. 1984;60:700–6.
White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd ed. Philadelphia: JB Lippincott; 1990.
Dvorak MF, Fisher CG, Fehlings MG, Rampersaud YR, Oner FC, Aarabi B, et al. The surgical approach to subaxial cervical spine injuries: an evidence-based algorithm based on the SLIC classification system. Spine (Phila Pa 1976). 2007;32(23):2620–9.
Kwon BK, Vaccaro AR, Grauer JN, Fisher CG, Dvorak MF. Subaxial cervical spine trauma. J Am Acad Orthop Surg. 2006;14:78–89.
Fisher CG, Dvorak MF, Leith J, Wing PC. Comparison of outcomes for unstable lower cervical flexion teardrop fractures managed with halo thoracic vest versus anterior corpectomy and plating. Spine. 2002;27:160–6.
Koivikko MP, Myllyen P, Karjalainen M, Vornanen M, Santavirta S. Conservative and operative treatment in cervical burst fracture. Arch Orthop Trauma Surg. 2000;120:448–51.
Cotler JM, Herbison GJ, Nasuti JF, Ditunno JF, An H, Wolff BE. Closed reduction of traumatic cervical spine dislocation using traction weights up to 140 pounds. Spine (Phila Pa 1976). 1993;18:386–90.
Hart RA, Vaccaro AR, Nachwalter RS. Cervical facet dislocations: when is magnetic resonance imaging indicated? Spine (Phila Pa 1976). 2002;27:116–7.
Vaccaro AR, Falatyn SP, Flanders AE, Balderston RA, Northrup BE, Cotler JM. Magnetic resonance evaluation of the intervertebral disc, spinal ligaments, and spinal cord before and after closed reduction of cervical spine dislocations. Spine (Phila Pa 1976). 1999;24:1210–7.
Rorabeck CH, Rock MG, Hawkins RJ, Bourne RB. Unilateral facet dislocation of the cervical spine: an analysis of the results of treatment in 26 patients. Spine (Phila Pa 1976). 1987;12:23–7.
Shapiro S, Snyder W, Kaufman K, Abel T. Outcome of 51 cases of unilateral locked cervical facets: interspinous braided cable for lateral mass plate fusion compared to interspinous wire and facet wiring with iliac crest. J Neurosurg. 1999;91(1 Suppl):19–24.
Dvorak M, Vaccaro AR, Hernsmeyer J, Norvell DC. Unilateral facet dislocations: is surgery really the preferred option? Evid Based Spine Care J. 2010;1:57–65.
Pang D, Wilberger JE. Spinal cord injury without radiographic abnormalities in children. J Neurosurg. 1982;57:114–29.
Bosch PP, Vogt MT, Ward T. Pediatric spinal cord injury without radiographic abnormality (SCIWORA). The absence of occult instability and lack of indication for bracing. Spine (Phila Pa 1976). 2002;27:2788–800.
Dickman CA, Zabramski JM, Hadley MN, Rekate HL, Sonntag VK. Pediatric spinal cord injury without radiographic abnormalities: report of 26 cases and review of the literature. J Spinal Disord. 1991;4:296–305.
Mahajan P, Jaffe DM, Olsen CS, Leonard JR, Nigrovic LE, Rogers AJ, et al. Spinal cord injury without radiologic abnormality in children imaged with magnetic resonance imaging. J Trauma Acute Care Surg. 2013;75(5):843–7.
Hwang M, Zebracki K, Chlan KM, Vogel LC. Longitudinal changes in medical complications in adults with pediatric-onset spinal cord injury. J Spinal Cord Med. 2014;37(2):171–8.
Zidek K, Srinivasan R. Rehabilitation of a child with a spinal cord injury. Semin Pediatr Neurol. 2003;10:140–50.
Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med. 1990;322(20):1405–11.
Bracken MB, Shepard MJ, Collins WF Jr, Holford TR, Baskin DS, Eisenberg HM, et al. Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. Results of the second National Acute Spinal Cord Injury Study. J Neurosurg. 1992;76(1):23–31.
Bracken MB, Shepard MJ, Holford TR, Leo-Summers L, Aldrich EF, Fazl M, et al. Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up. Results of the third National Acute Spinal Cord Injury randomized controlled trial. J Neurosurg. 1998;89(5):699–706.
Bracken MB, Shepard MJ, Holford TR, Leo-Summers L, Aldrich EF, Fazl M, et al. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the third National Acute Spinal Cord Injury randomized controlled trial. JAMA. 1997;277(20):1597–604.
Pettiford JN, Bikhchandani J, Ostlie DJ, St Peter SD, Sharp RJ, Juang D. A review: the role of high dose methylprednisolone in spinal cord trauma in children. Pediatr Surg Int. 2012;28:287–94.
Fehlings MG, Vaccaro A, Wilson JR, Singh A, W Cadotte D, Harrop JS, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the surgical timing in acute spinal cord injury study (STASCIS). PLoS One. 2012;7(2):e32037.
Li YL, Hedequist D. Traumatic pediatric spine injuries. In: Rau RD, editor. Orthopaedic knowledge update: spine. 4th ed. Rosemont: Americal Academy of Orthopaedic Surgeons; 2012. p. 467.
Editors and Affiliations
© 2018 Springer Science+Business Media LLC
About this chapter
Cite this chapter
Shah, M., Herman, M.J., Eberson, C., Anderson, J.T. (2018). Pediatric and Adolescent Cervical Spine Trauma. In: Hedequist, D., Shah, S., Yaszay, B. (eds) The Management of Disorders of the Child’s Cervical Spine. Springer, Boston, MA. https://doi.org/10.1007/978-1-4939-7491-7_6
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4939-7489-4
Online ISBN: 978-1-4939-7491-7