The severity of injury to the cervical spine (the upper portion of the spine including the neck and just below the neck) depends on where the spine was damaged.
The bony spine protects a tube-like spinal column with its nerves that help control muscles to various sections of the body. The seven cervical vertebrae, at the top portion of the spine, have eight nerve pairs.
The pediatric spinal column is more elastic than in older people. This elasticity provides some protection against injury that might cause a fracture in older patients. The juvenile spine will stretch, but does not usually break; however, it can sustain serious injury.
Injuries to the cervical spine can produce varying results depending on the location of the injury and its severity. Some examples include:
The highest incidence of spinal injury occurs in adolescents and young adults 16-24 years old. Once patients reach 15-16 years old (and have generally reached skeletal maturity), spine injuries resemble those of adults.
The most common cervical spine injury in adolescents is at the C5 and C6 level.
The most common spinal cord injuries in the lower cervical spine occur as a result of:
Some additional causes of lower cervical spine injuries include:
To diagnose lower cervical spine injuries, physicians at The Children's Hospital of Philadelphia (CHOP) perform a comprehensive physical examination and detailed family history of the child.
We also use the following imaging tests to help determine your child’s diagnosis and the potential cause of the traumatic spine injury.
Spine surgeons at CHOP have extensively studied the use of MRI in assessing cervical spine injuries, particularly for patients who are non-verbal or comatose. In some cases, the MRI uncovered additional injuries that X-rays did not document. With more detailed information, clinicians are able to create a customized treatment plan. Read the study abstract for details.
Physicians treat lower cervical spine injuries with a variety of surgical and nonsurgical approaches. At CHOP, treatment recommendations depend on the location and severity of the child's injury, as well as other individual factors.
Treatment options include:
If your child needs surgery, we take every precaution to ensure safety in spine surgery. Our multidisciplinary approach helps us to address all aspects of your child’s care and treatment.
We offer a wealth of ongoing support and services to patients and their families. Your child will have access to clinical services such as physical and occupational therapy, as well as psychosocial support from social workers and psychologists who can help your child deal with any emotional effects of the injury.
Surgery can improve traumatic spine injuries, but it can also be a stressful experience for you and your child. Our team can help you prepare your child for surgery and know what to expect during surgery.
We also recognize your child's pediatrician or referring physician as an important part of the care team and provide regular updates about your child's progress.
Anytime your child has sustained a spine injury, it is important to follow up with a physician. Careful and consistent ongoing care is essential to ensure your child is healing properly — whether your child had surgery or not.
Your child's physician will suggest a follow-up schedule for your child. Continuing care is available at CHOP's Main Campus or at a CHOP Care Network location.
Our pediatric clinical professionals will follow your child until young adulthood (between age 18 and 21) and help transition to adult orthopedic care, if needed.
Long-term outcomes for pediatric patients with lower cervical spine injuries can vary greatly depending on the injury location and severity. At Children's Hospital, we work with you and your child to achieve the best possible outcome and quality of life for your child.
To make an appointment with the Division of Orthopedic Surgery at The Children's Hospital of Philadelphia, call 215-590-1527 or contact us online.
Reviewed by: Sean Kearney, MD, and John P. Dormans, MD, FACS
Date: January 2013