Management of cervical spine trauma in children

Eur J Trauma Emerg Surg. 2019 Oct;45(5):777-789. doi: 10.1007/s00068-018-0992-x. Epub 2018 Aug 24.


Purpose: Paediatric cervical spine injuries are fortunately a rare entity. However, they do have the potential for devastating neurological sequelae with lifelong impact on the patient and their family. Thus, management ought to be exceptional from the initial evaluation at the scene of the injury, through to definitive management and rehabilitation.

Methods: We set out to review cervical spine injuries in children and advise on current best practice with regards to management.

Results: Epidemiology, initial management at the scene of injury, radiological findings and pitfalls of cervical spine trauma are outlined. Strategies for conservative and surgical management are detailed depending on the pattern of injury. The management of spinal cord injuries without radiological abnormality (SCIWORA) and cranio-cervical arterial injuries is also reviewed.

Conclusions: Due to a paucity of evidence in these rare conditions, expert opinion is necessary to guide best practice management and to ensure the best chance of a good outcome for the injured child.

Keywords: Cervical spine; Children; Fracture; Pediatric; SCIWORA; Trauma.

Publication types

  • Review

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / injuries*
  • Child
  • Child, Preschool
  • Emergency Medical Services / methods*
  • Guideline Adherence*
  • Humans
  • Immobilization / methods*
  • Injury Severity Score
  • Prospective Studies
  • Radiography
  • Spinal Cord Injuries / diagnostic imaging
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / rehabilitation
  • Spinal Cord Injuries / therapy*
  • Spinal Injuries / diagnostic imaging
  • Spinal Injuries / physiopathology
  • Spinal Injuries / rehabilitation
  • Spinal Injuries / therapy*
  • Time-to-Treatment
  • Transportation of Patients / methods