Declining rates of cervical spine injury and operative intervention in pediatric trauma: A national TQIP analysis.

INTRODUCTION

Pediatric cervical spine injuries (CSI) are present in 1-2% of all pediatric traumatic injuries and can be devastating. Contemporary injury prevention measures may decrease CSI incidence, however, their impact on pediatric CSI incidence are unknown. We aimed to evaluate contemporary epidemiological data of pediatric CSI in the United States.

METHODS

We evaluated the incidence of pediatric CSI using the Trauma Quality Improvement Program (TQIP) database from 2017 to 2024. Amongst children (age 0-17) with blunt trauma, CSI cases and CSI-related operative interventions were identified using ICD-10-CM and ICD-10-PCS codes, respectively. Trends in the incidence of overall and operative CSI were assessed for the total cohort and across age groups. P < 0.05 was defined as statistically significant.

RESULTS

Among 805,466 pediatric patients with blunt trauma the overall incidence of CSI was 1.9% (<1 years: 0.5%, 1-4 years: 1.0%, 5-9 years: 0.9%, 10-14 years: 1.7%, 15-17 years: 4.4%). Increasing age and motor vehicle accident mechanism were independently associated with CSI. There was a significant decrease in overall- (2017: 2.08 %, 2024: 1.8%) and operative- (2017: 15.3%, 2024: 12.5%) CSI incidence across the study period, not explained by changes in overall trauma volume.

CONCLUSIONS

Among traumatically injured children presenting to trauma centers in the United States, the incidence of CSI is decreasing over time. These findings suggest that public health measures such as improving vehicle safety standards, restraint- and helmet-laws may have a measurable impact on this potentially devastating pediatric injury pattern.