Spinal trauma in children and adolescents: mechanisms of injury, anatomical characteristics and principles of treatment

Spinal trauma in children and adolescents, including spinal cord injury, fractures and dislocations, is relatively uncommon, but represents the highest risk of morbidity and mortality of all paediatric injuries. Motor vehicle accidents, falls from heights and sport accidents resulting in blunt trauma are the most frequent mechanisms of injury. The average age of presentation is approximately 12 years old. Injury following spinal trauma differs according to age-specific biomechanical characteristics of the developing spine. The most common site of injury in younger children is the cervical spine, whereas injury to the thoracolumbar spine is more common in adolescents. Differential diagnosis following trauma should include physiological particularities of the developing spine. Search for concomitant lesions is mandatory as patients frequently present with more than one vertebral fracture. Injury in this population can significantly affect the developing spine leading to neurological trauma and progressive deformity.