Pediatric Cervical Spine and Spinal Cord Injuries

1

What challenges do children present in evaluation of neck injuries?

Young children are not always able to reliably communicate the extent or even location of their injuries. You must rely on observation of their behaviors and response to your evaluation to guide interventions.

2

What special considerations are there in evaluation of neck injury in children?

Children have relatively larger heads and shorter necks than their adult counterparts. This causes the fulcrum of the spine to be located higher in the neck. When cervical spine injuries occur in children, they are more likely to occur in the upper cervical spine (C1–C4).

Additionally, the structures within children’s necks are more mobile and their muscles are relatively weak, allowing for soft tissue and spinal cord injuries without fracture.

3

What is SCIWORA?

SCIWORA is an acronym for Spinal Cord Injury WithOut Radiographic Abnormality. In addition to more mobile neck structures, the shape and development of the pediatric cervical spine make children more prone to these injuries. The facet joints of the cervical vertebrae in children are oriented horizontally, allowing for increased movement of the bones relative to each other. Their cervical vertebrae are also not fully ossified, making the bones themselves more flexible.