Points & Pearls Excerpt

• Pediatric cervical spine injury (CSI) is rare (1% to 1.5% of blunt trauma patients) but carries a mortality of 5% to 28% and high long-term morbidity. Upper CSI is most common in younger children, while subaxial injuries are most common in children aged >8 years.
• Anatomic differences in young children predispose them to upper CSI. The fulcrum migrates to C5 to C6 after approximately age 9, and injury patterns become adult-like.
• Spinal cord injury without radiographic abnormality (SCIWORA) is more common in children than adults due to greater elasticity of ligaments and tendons. Symptom onset may be delayed by hours to days after the injury.