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Spine Injury: Cervical, Pediatric

Spine Injury: Cervical, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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  • Relatively rare, present in 1–2% of patients with severe blunt trauma
  • Children <8 yr of age are more likely to have upper cervical spine injuries (C1–C3) and are at risk of growth plate injuries:
    • Spinal fulcrum is higher (C2–C3 at birth)
    • Relatively larger head to body
    • Weaker cervical musculature
    • Ligamentous laxity
    • Immature vertebral joints
  • Children >8 yr of age:
    • Increased incidence of pancervical injuries
    • Vertebral body and arch fractures
    • Lower cervical spine injuries more common
  • Special considerations:
    • Down syndrome
    • Klippel–Feil syndrome
    • Morquio syndrome
    • Larsen syndrome
  • Spinal cord injury without radiographic abnormality (SCIWORA):
    • Based on study population, incidence from 4.5–35% of children with spinal injuries
    • More common in children <8 yr of age
    • May present as definite spinal cord injury:
      • Spinal shock
      • Neurologic deficits
    • Symptoms may be transient and have resolved by time of evaluation:
      • Paresthesias
      • Burning sensation of hands
      • Weakness
    • Symptoms often occur immediately after injury but may have delayed onset (i.e., minutes to days).


  • Birth – breech vaginal delivery
  • <8 yr – MVC and falls
  • >8 yr – MVC and sports injuries

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Rosen, Peter, et al., editors. "Spine Injury: Cervical, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307221/all/Spine_Injury:_Cervical__Pediatric.
Spine Injury: Cervical, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307221/all/Spine_Injury:_Cervical__Pediatric. Accessed April 25, 2019.
Spine Injury: Cervical, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307221/all/Spine_Injury:_Cervical__Pediatric
Spine Injury: Cervical, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307221/all/Spine_Injury:_Cervical__Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Spine Injury: Cervical, Pediatric ID - 307221 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307221/all/Spine_Injury:_Cervical__Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -