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Multicenter Study
. 2020 Nov;106(7):1245-1249.
doi: 10.1016/j.otsr.2020.06.015. Epub 2020 Oct 12.

Epidemiology of spinal fractures in children: Cross-sectional study

Roxane Compagnon  1 , Emmanuelle Ferrero  2 , Julien Leroux  3 , Yan Lefevre  4 , Pierre Journeau  5 , Rapahël Vialle  6 , Christophe Glorion  7 , Philippe Violas  8 , Antoine Chalopin  9 , Thierry Odent  10 , Elie Haddad  11 , Jérémie Nallet  12 , Christophe Garin  13 , Elie Choufani  14 , Tristan Langlais  15 , Jérôme Sales de Gauzy  16 ; French Society of Spinal Surgery (SFCR), French Society of Pediatric Orthopedics (SOFOP)  17
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Free article
Multicenter Study

Epidemiology of spinal fractures in children: Cross-sectional study

Roxane Compagnon et al. Orthop Traumatol Surg Res. 2020 Nov.
Free article

Abstract

Introduction: Epidemiological studies of fractures of the spine in children are all old, mostly single-centre, with series spanning periods of 5 to 20 years.

Hypothesis: As lifestyle is constantly changing, notably with an increase in sports activities and improvements in the prevention of road and household accidents, epidemiology has likely changed.

Objective: To update the description of spinal trauma in children and adolescents compared to the existing literature.

Material and method: A multicentre cross-sectional study of spinal fracture, dislocation and spinal cord injury without radiological abnormality (SCIWORA) in children was carried out in 15 French university hospital centres, for a period of one year (2016).

Results: One hundred and sixty-five children were identified: 85 girls, 80 boys; mean age 11 years (range, 10 months-17 years); median, 12 years 6 months. One hundred and fifty-two children (92%) had fracture, 8 (5%) dislocation (including 7 C1-C2 rotary dislocations), and 5 (3%) SCIWORA. Fractures were multiple in 80 cases (49%), contiguous in 73 cases (91%) and non-contiguous in 7 (9%). Locations were cervical in 25 cases (15%), thoracic in 85 (52%), lumbar in 75 and sacral in 4 (2%). Fracture types comprised 234 vertebral compactions (78%), 25 burst fractures (8%), 5 chance fractures (2%), 2 odontoid fractures, and 33 other lesions. Causes comprised fall in 77 cases (47%), sports accidents in 56 (34%), road accidents in 29 (18%), and others in 3. In 52 cases (32%), there was ≥1 associated lesion: appendicular in 35 cases (67%), thoracic or abdominal in 31 (60%), and head in 16 (31%). Twenty-one cases had multiple lesions (40%). Eighteen cases showed neurological involvement (11%) including 5 SCIWORAs. Neurological complications were more frequent before 9 years of age.

Conclusion: The epidemiology of spine fractures in children has slightly changed. There are now fewer cervical lesions. Causes are less often road accidents and more often sports accidents. Multi-level lesions remain frequent and the rate of neurological complications is around 10%. Compaction fracture is the most common type.

Keywords: Children and adolescents; Epidemiology; SCIWORA; Spinal fracture; Spinal trauma.

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