PEDIATRIC CERVICAL SPINE INJURIES

Cervical spine injuries in children, although rare, can have severe consequences. The flexible structure of the paediatric spine and the increased resilience of connective tissue contribute to the lower inci-dence of such injuries; however, the likelihood rises with the severity of trauma. In young children, most cervical spine injuries occur in the upper cervical region. The upper cervical spine in children is more flexible and less developed compared to adults, making it more susceptible to trauma. These injuries are commonly associated with high-energy trauma, such as motor vehicle accidents and falls. Cervical injuries frequently coexist with head trauma. Paediatric cervical spine injuries can be clas-sified into fractures, distraction injuries, and SCIWORA (Spinal Cord Injury Without Radiographic Abnormality). While distraction injuries are more prevalent in younger children, fractures are more common in older children. The diagnosis and management process varies depending on the child’s age and the severity of the injury. Early diagnosis is crucial to prevent significant morbidity. The diagnosis and treatment of cervical spine trauma in children differ from those in adults and require careful eval-uation. The NEXUS criteria guide the need for cervical imaging: altered consciousness, intoxication, neck tenderness, neurological deficits, and distracting injuries. Cervical imaging should be performed if any of these criteria are met. Imaging in paediatric cervical trauma is challenging due to the im-mature skeletal structures. Upper cervical injuries are assessed using specific measurements, such as the atlanto-dens interval and prevertebral space. Anatomical differences, such as pseudosubluxation, may lead to misinterpretation of trauma. Treatment is typically conservative but may require surgical intervention in severe cases. Methods include external immobilisation (halo vest), traction, and surgi-cal stabilisation. Management of cervical instability in children must preserve growth potential. The prognosis for upper cervical injuries is poor, with high mortality rates, especially in the presence of head trauma and neurological deficits.