Die Wirbelsäule 2017; 01(03): 171-182
DOI: 10.1055/s-0043-109437
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Verletzungen der Halswirbelsäule im Kindes- und Jugendalter

Injuries of the cervical spine in childhood and adolescence
J. S. Jarvers
,
A. Völker
,
N. von der Höh
,
C. Josten
,
C. E. Heyde
Further Information

Publication History

Publication Date:
24 August 2017 (online)

Zusammenfassung

Kommt es bei Säuglingen und Kleinkindern eher zu Verletzungen des zervikothorakalen Übergangs und der oberen HWS, so finden sich mit zunehmendem Alter zumeist Verletzungen der unteren HWS, aufgrund der zu der erwachsenen Wirbelsäule mehr und mehr angeglichenen Anatomie und Biomechanik.

Aufgrund des seltenen Auftretens von HWS-Verletzungen im Kindes- und Jugendalter bedarf es einer genauen Kenntnis möglicher Verletzungsformen und der physiologischen Entwicklung der HWS einschließlich möglicher Anomalien, um die Verletzungen nicht zu übersehen und um die adäquate Therapie einzuleiten.

Je nach Lokalisation und Verletzungen kommen konservative Therapiemaßnahmen mit Ruhigstellung in Orthesen oder dem Halofixateur in Betracht. Bei entsprechendem Verletzungsmuster können jedoch auch im Kindesalter Osteosynthesen und Fusionen notwendig werden.

Abstract

Infants and small children tend to injuries of the cervicothoracic transition and the upper cervical spine, while older children rather present injuries in the lower cervical spine due to the anatomy and biomechanics that are more and more adapted to the adult spine.

Due to the rare occurrence of cervical spine injuries in childhood and adolescence, it is necessary to have an accurate knowledge of possible injuries, the physiological development, including anomalies, in order not to overlook injuries and to initiate adequate therapy.

Depending on the localization and injuries, conservative therapy with immobilization in orthosis or the Halo-Fixateur can be considered. However, osteosynthesis or fusion may also become necessary in the case of an appropriate pattern of injury.

 
  • Literatur

  • 1 Reynolds R. Pediatric spinal injury. Curr Opin Pediatr 2000; 12: 67-71
  • 2 Goldstein HE, Anderson RC. Classification and Management of Pediatric Craniocervical Injuries. Neurosurg Clin N Am 2017; 28: 73-90
  • 3 Rüter A, Trentz O, Wagner M. Unfallchirurgie. München: Urban & Schwarzenberg; 1995: 151-155
  • 4 Morscher E, Jani LWirbelfrakturen. In: Saurer H. (Hrsg) Das verletzte Kind, Lehrbuch der Kindertraumatologie. Stuttgart: Thieme; 1984: 413-426
  • 5 Adib O, Berthier E, Loisel D. et al. Pediatric cervical spine in emergency: radiographic features of normal anatomy, variants and pitfalls. Skeletal Radiol 2016; 45: 1607-1617
  • 6 Ribeiro da Silva M, Linhares D. et al. Paediatric cervical spine injures Nineteen years experience of a single centre. Int Orthop. 2016; 40: 1111-1116.
  • 7 Knox JB, Schneider JE, Cage JM. et al. Spine trauma in very young children: a retrospective study of 206 patients presenting to a level 1 pediatric trauma center. J Pediatr Orthop 2014; 34: 698-702.
  • 8 Hill SA, Miller CA, Kosnik EJ. et al. Pediatric neck injuries – a clinical study. J Neurosurg 1984; 60: 700-706
  • 9 Brown RL, Brunn MA, Garcia VF. Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Ped Surg 2001; 36: 1107-1114
  • 10 Piatt Jr JH . Pediatric spinal injury in the US: epidemiology and disparities. J Neurosurg Pediatr 2015; 16: 463-471
  • 11 Knox J. Epidemiology of spinal cord injury without radiographic abnormality in children: a nationwide perspective. J Child Orthop 2016; 10: 255-60
  • 12 Schrödel M, Hertlein H. Halswirbelsäulenverletzungen im Kindes- und Jugendalter. Unfallchirurg 2013; 116: 1054-1061
  • 13 Rush JK, Kelly DM, Astur N. et al. Associated injuries in children and adolescents with spinal trauma. J Pediatr Orthop 2013; 33: 393-397
  • 14 Nau C, Rose S, Laurer H. et al. Wirbelsäulenverletzungen Im Kindesalter. Orthop Unfallchir Up2date 2010; 5: 23-38
  • 15 Warner WC, Beaty JH, Kasser JR. Cervical spine injuries in children. Rockwood and Wilkins‘ fractures in children. Baltimore: Lippincott Williams & Wilkins; 2001: 809-846
  • 16 Chaudhry AS, Prince J, Sorrentino C. et al. Identification of Risk Factors for Cervical Spine Injury from Pediatric Trauma Registry. Pediatr Neurosurg 2016; 51: 167-174
  • 17 Jarvers JS, Spiegl U, von der Höh N. et al. Verletzungen der kindlichen thorakolumbalen Wirbelsäule. Orthopade. 2016; 45: 472-483
  • 18 Sensakovic WF, O'Dell MC, Agha A. et al. CT Radiation Dose Reduction in Robot-assisted Pediatric Spinal Surgery. Spine 2017; 42: E417-E424
  • 19 Harrigan MR, Hadley MN, Dhall SS. et al. Management of Vertebral Artery Injuries Following Non-Penetrating Cervical Trauma. Neurosurgery 2013; 72: 234-43
  • 20 Pang D. Spinal cord injury with radiographic abnormality in children, 2 decades later. Neurosurgery 2004; 55 : 1325-1343
  • 21 McCracken B, Klineberg E, Pickard B. et al. Flexion and extension radiographic evaluation for the clearance of potential cervical spine injures in trauma patients. European spine journal 2013; 22: 1467-1473
  • 22 Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fracture. Spine 1988; 13: 731-736
  • 23 Bono C, Vaccaro AR, Fehlings M. et al. Measurement techniques for upper cervical spine injuries: Consensus statement of the Spine. Trauma Study Group. Spine 2007; 32: 593-600
  • 24 Jeszenszky D, Fekete TF, Lattig F. et al. Intraarticular atlantooccipital fusion for the treatment of traumatic occipitocervical dislocation in a child: a new technique for selective stabilization with nine years follow-up. Spine (Phila Pa 1976) 2010; 35: E421-E426
  • 25 Reichman EF, Shah J. Grisel Syndrome: An Unusual and Often Unrecognized Cause of Torticollis. Pediatr Emerg Care 2015; 31: 577-5780
  • 26 Weisskopf M, Naeve D, Ruf M. et al. Therapeutic options and results following fixed atlantoaxial rotatory dislocations. Eur Spine J 2005; 14: 61-68
  • 27 Powell EC, Leonard JR, Olsen CS. et al. Atlantoaxial Rotatory Subluxation in Children. Pediatr Emerg Care 2017; Feb;33: 86-91.
  • 28 Vaccaro AR, Koerner JD, Radcliff KE. et al. AOSpine subaxial cervical spine injury classification system. Eur Spine J. 2016; 25: 2173-2184
  • 29 Kokoska ER, Keller MS, Rallo MC. et al. Characteristics of pediatric cervical spine injuries. J Pediatr Surg 2001; 36: 100-105
  • 30 Kim C, Vassilyadi M, Forbes JK. et al. Traumatic spinal injuries in children at a single level 1 pediatric trauma centre: report of a 23-year experience. Can J Surg. 2016 Jun 59: 205-212