Spinal trauma in childhood - A four-year experience at a non-specialist hospital

Trauma remains one of the major causes of death in children and adolescents. The mechanisms underlying response to traumatic injury differ radically in adults and children for anatomical and biomechanical reasons. This study is a retrospective review of all patients admitted to our hospital with suspect spinal trauma from 1999 to date, analysing in children the incidence, type of bone injury, possible spinal cord involvement and clinical condition on discharge. Of 143 cases of spinal trauma examined at our hospital over a four-year period by x-ray, computed tomography and magnetic resonance imaging, 21 were aged between six and 16 years. In agreement with literature reports, the incidence was lower than that in adults, but carried a worse prognosis. Although not common, spinal trauma in childhood entails a high incidence of severe permanent neurological disability due to direct involvement of the spinal cord. It is necessary for neuoradiologists to be familiar with problems relating to the biomechanics of the spine in childhood since prompt diagnosis may reduce the neurological deficits and allow appropriate management Of these young patients.