Paediatric spine injuries in the thoracic and lumbar spine-results of the German multicentre CHILDSPINE study.

Autor: Herren C; Department of Orthopedic Trauma Surgery, University Hospital RWTH Aachen, Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. cherren@ukaachen.de., Jarvers JS; Universitätsklinikum Leipzig, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Leipzig, Germany., Jung MK; BG Klinik Ludwigshafen, Zentrum für Wirbelsäulenchirurgie, Ludwigshafen Am Rhein, Germany., Blume C; Uniklinik RWTH Aachen, Klinik für Neurochirurgie, Aachen, Germany., Meinig H; SRH Klinikum Karlsbad-Langensteinbach, Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, Karlsbad, Germany., Ruf M; SRH Klinikum Karlsbad-Langensteinbach, Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, Karlsbad, Germany., Weiß T; BG Unfallklinik Murnau, Abteilung Wirbelsäulenchirurgie, Staffelsee, Germany., Rüther H; Universitätsmedizin Göttingen, Zentrum für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Göttingen, Germany., Welk T; SRH Klinikum Karlsbad-Langensteinbach, Abteilung für Radiologie und Neuroradiologie, Karlsbad, Germany., Badke A; BG Klinik Tübingen, Abteilung für Wirbelsäulenchirurgie, Tübingen, Germany., Gonschorek O; BG Unfallklinik Murnau, Abteilung Wirbelsäulenchirurgie, Staffelsee, Germany., Heyde CE; Universitätsklinikum Leipzig, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Leipzig, Germany., Kandziora F; BG Unfallklinik Frankfurt, Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, Frankfurt Am Main, Germany., Knop C; Klinikum Stuttgart, Klinik für Unfallchirurgie und Orthopädie, Stuttgart, Germany., Kobbe P; Department of Orthopedic Trauma Surgery, University Hospital RWTH Aachen, Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany., Scholz M; BG Unfallklinik Frankfurt, Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, Frankfurt Am Main, Germany., Siekmann H; Ameos Klinik Halberstadt, Klinik für Unfall, Hand- und Wiederherstellungschirurgie, Halberstadt, Germany., Spiegl U; Universitätsklinikum Leipzig, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Leipzig, Germany., Strohm P; Klinikum Bamberg, Klinik für Orthopädie und Unfallchirurgie, Bamberg, Germany., Strüwind C; BG Unfallklinik Murnau, Abteilung Wirbelsäulenchirurgie, Staffelsee, Germany., Matschke S; ATOS Klinik Heidelberg, Praxis für Wirbelsäulenchirurgie, Heidelberg, Germany., Disch AC; Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, UniversitätsWirbelsäulenzentrum (UCSC), UniversitätsCentrum für Orthopädie, Unfall- and Plastische Chirurgie, Dresden, Germany., Kreinest M; BG Klinik Ludwigshafen, Zentrum für Wirbelsäulenchirurgie, Ludwigshafen Am Rhein, Germany.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Apr; Vol. 33 (4), pp. 1574-1584. Date of Electronic Publication: 2023 Jul 19.
DOI: 10.1007/s00586-023-07822-1
Abstrakt: Background: Paediatric thoracolumbar spine injuries are rare, and meaningful epidemiological data are lacking.
Objectives: The aim of this study was to provide epidemiological data for paediatric patients with thoracolumbar spinal trauma in Germany with a view to enhancing future decision-making in relation to the diagnostics and treatment of these patients.
Materials and Methods: A retrospective multicentre study includes patients up to 16 years of age who were suffering from thoracolumbar spine injuries who had been treated in six German spine centres between 01/2010 and 12/2016. The clinical database was analysed for patient-specific data, trauma mechanisms, level of injury, and any accompanying injuries. Diagnostic imaging and subsequent treatment were investigated. Patients were divided into three age groups for further evaluation: age group I (0-6 years), age group II (7-9 years) and age group III (10-16 years).
Results: A total of 153 children with 345 thoracolumbar spine injuries met the inclusion criteria. The mean age at the time of hospitalization due to the injury was 12.9 (± 3.1) years. Boys were likelier to be affected (1:1.3). In all age groups, falls and traffic accidents were the most common causes of thoracolumbar spine injuries. A total of 95 patients (62.1%) were treated conservatively, while 58 (37.9%) of the children underwent surgical treatment. Minimally invasive procedures were the most chosen procedures. Older children and adolescents were likelier to suffer from higher-grade injuries according to the AOSpine classification. The thoracolumbar junction (T11 to L2) was the most affected level along the thoracolumbar spine (n = 90). Neurological deficits were rarely seen in all age groups. Besides extremity injuries (n = 52, 30.2%), head injuries represented the most common accompanying injuries (n = 53, 30.8%). Regarding spinal injuries, most of the patients showed no evidence of complications during their hospital stay (96.7%).
Conclusions: The thoracolumbar junction was more frequently affected in older children and adolescents. The majority of thoracolumbar spinal column injuries were treated conservatively. Nevertheless, 37.9% of hospitalized children had to be treated surgically, and there was an acceptable complication rate for the surgeries that were performed.
(© 2023. The Author(s).)
Databáze: MEDLINE
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