Cervical spinal cord injury in children.

We examined 19 children under 10 years of age with cervical spinal cord injury using clinical records and radiographs. The children were divided into two groups: Eight had immediate and complete spinal cord injury, and 11 had incomplete or partial spinal cord injury. Those with complete spinal cord injury were injured in motor vehicle accidents with a proximal spinal cord injury. Eighty-eight percent had cervical spine fractures/instability with a distraction pattern of injury. Half had associated trauma. The mortality rate was 25%, and those who survived showed no neurologic improvement. Most of the children with partial spinal cord injury were injured at birth. Many had no radiographic evidence of cervical fracture. One-quarter had associated trauma. The neurologic improvement averaged 1.9 Frankel grades. Half of both groups required posterior cervical fusion, and there was a significant complication rate. Eight-eight percent developed scoliosis, and 71% developed hip subluxation.