Birinci Düzey Travma Merkezinde Pediyatrik Servikal Travmaların Tedavisi
Yıl 2020,
, 157 - 160, 01.08.2020
M Özgür Taşkapılıoğlu
,
Pınar Eser Ocak
Oğuz Altunyuva
,
Şeref Doğan
Öz
Pediatrik spinal yaralanmalar nadir görülen bir durumdur ancak bu hastaların tedavileri ile ilgili kesinleşmiş kriterler ortaya konulamamıştır. Bu çalışmada kliniğimizde Ocak 2010- Aralık 2019 tarihleri arasında takip ve tedavi edilen pediatrik hastaların dosyaları retrospektif olarak incelenmiştir. Çalışmamıza 23 hasta dahil edilmiştir. Hastaların 15 (%65.2) tanesi erkek, 8’i (%34.7) kadındı. Olguların büyük çoğunluğunun etiyolojisinde düşme ve trafik kazası (%73.9) vardı. 8 hastada fraktür, 11 hastada subluksasyon saptandı. Hastaların 17 tanesi konservatif olarak tedavi edilirken, 6 hasta cerrahi olarak tedavi edildi. Servikal spinal yaralanmalar çocukluk çağında tanı ve tedavi açısından özellik ve dikkat gerektiren bir durumdur. Bu durumun yönetiminde çocukluklar ile erişkinlerin arasındaki anatomik farkların iyi bilinmesi hayati önem taşır.
Kaynakça
- 1. Galano GJ, Vitale MA, Kessler MW, Hyman JE, Vitale MG. The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population. J Pediatr Orthop 2005; 2: 39-44.
- 2. Eubanks JD, Gilmore A, Bess S, Cooperman DR. Clearing the pediatric cervical spine following injury. J Am Acad Orthop Surg. 2006;14(9):552–564.
- 3. Pang D. Spinal cord injuries. McLone DG (ed), Pediatric Neurosurgery, 4th ed, Philadelphia: WB Saunders, 2001: 660-694
- 4. Jain A, Brooks JT, Rao SS, Ain MC, Sponseller PD. Cervical fractures with associated spinal cord injury in children and adolescents: epidemiology, costs, and in-hospital mortality rates in 4418 patients. J Child Orthop 2015; 9: 171–175.
- 5. Hakan Karabağlı Omurga yaralanmaları ve tedavisi Pediatrik Nöroşirurji Ed: Baykaner K, Erşahin Y, Mutluer S, Özek M Türk Nöroşirurji Derneği yayınları Ankara 755-766
- 6. Baumann F, Ernstberger T, Neumann C, Nerlich M, Schroeder GD, Vaccaro AR, Loibl M. Pediatric cervical spine injuries: a rare but challenging entity. J Spinal Disord Tech. 2015;28(7):E377-384.
- 7. Patel JC, Tepas JJ III, Mollitt DL, Pieper P. Pediatric cervical spine injuries: defining the disease. J Pediatr Surg. 2001;36(2):373–376.
- 8. Hale AT, Alvarado A, Bey AK, Pruthi S, Mencio GA, Bonfield CM, Martus JE, Naftel RP. X-ray vs. CT in identifying significant C-spine injuries in the pediatric population. Childs Nerv Syst. 2017;33(11):1977-1983
- 9. Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, Mirza SK. The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst. 2005;21(2):122-127.
10. Herman MJ, Brown KO, Sponseller PD, Phillips JH, Petrucelli PM, Parikh DJ, Mody KS, Leonard JC, Moront M, Brockmeyer DL, Anderson RCE, Alder AC, Anderson JT, Bernstein RM, Booth TN, Braga BP, Cahill PJ, Joglar JM, Martus JE, Nesiama JO, Pahys JM, Rathjen KE, Riccio AI, Schulz JF, Stans AA, Shah MI, Warner WC Jr, Yaszay B. Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group. J Bone Joint Surg Am. 2019;101(1):e1.
- 11. Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-2284.
- 12. Copley PC, Tilliridou V, Kirby A, Jones J, Kandasamy J. Management of cervical spine trauma in children. Eur J Trauma Emerg Surg. 2019;45(5):777-789
- 13. Geuther M, Grassner L, Mach O, Klein B, Högel F, Voth M, Bühren V, Maier D, Abel R, Weidner N, Rupp R, Fürstenberg CH; EMSCI study group, Schneidmueller D. Functional outcome after traumatic cervical spinal cord injury is superior in adolescents compared to adults. Eur J Paediatr Neurol. 2019;23(2):248-253.
Treatment of Pediatric Cervical Trauma in the First Level Trauma Center
Yıl 2020,
, 157 - 160, 01.08.2020
M Özgür Taşkapılıoğlu
,
Pınar Eser Ocak
Oğuz Altunyuva
,
Şeref Doğan
Öz
Pediatric spinal injuries are rare conditions. Although there are many studies on this subject, certain criteria regarding the treatment of these patients have not been revealed. In this study, the files of pediatric patients who were followed up and treated in our clinic between January 2010 and December 2019 were analyzed retrospectively. 23 patients were included in our study. 15 (65.2%) of the patients were male and 8 (34.7%) were female. The vast majority of cases had a fall in etiology and a traffic accident (73.9%). Fracture was detected in 8 patients and subluxation in 11 patients. 17 patients were treated conservatively, while 6 patients were treated surgically. Cervical spinal injuries are rare conditions that requires special attention in terms of diagnosis and treatment in childhood. In the management of this condition, it is vital to know the anatomical differences between childhoods and adults.
Kaynakça
- 1. Galano GJ, Vitale MA, Kessler MW, Hyman JE, Vitale MG. The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population. J Pediatr Orthop 2005; 2: 39-44.
- 2. Eubanks JD, Gilmore A, Bess S, Cooperman DR. Clearing the pediatric cervical spine following injury. J Am Acad Orthop Surg. 2006;14(9):552–564.
- 3. Pang D. Spinal cord injuries. McLone DG (ed), Pediatric Neurosurgery, 4th ed, Philadelphia: WB Saunders, 2001: 660-694
- 4. Jain A, Brooks JT, Rao SS, Ain MC, Sponseller PD. Cervical fractures with associated spinal cord injury in children and adolescents: epidemiology, costs, and in-hospital mortality rates in 4418 patients. J Child Orthop 2015; 9: 171–175.
- 5. Hakan Karabağlı Omurga yaralanmaları ve tedavisi Pediatrik Nöroşirurji Ed: Baykaner K, Erşahin Y, Mutluer S, Özek M Türk Nöroşirurji Derneği yayınları Ankara 755-766
- 6. Baumann F, Ernstberger T, Neumann C, Nerlich M, Schroeder GD, Vaccaro AR, Loibl M. Pediatric cervical spine injuries: a rare but challenging entity. J Spinal Disord Tech. 2015;28(7):E377-384.
- 7. Patel JC, Tepas JJ III, Mollitt DL, Pieper P. Pediatric cervical spine injuries: defining the disease. J Pediatr Surg. 2001;36(2):373–376.
- 8. Hale AT, Alvarado A, Bey AK, Pruthi S, Mencio GA, Bonfield CM, Martus JE, Naftel RP. X-ray vs. CT in identifying significant C-spine injuries in the pediatric population. Childs Nerv Syst. 2017;33(11):1977-1983
- 9. Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, Mirza SK. The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst. 2005;21(2):122-127.
10. Herman MJ, Brown KO, Sponseller PD, Phillips JH, Petrucelli PM, Parikh DJ, Mody KS, Leonard JC, Moront M, Brockmeyer DL, Anderson RCE, Alder AC, Anderson JT, Bernstein RM, Booth TN, Braga BP, Cahill PJ, Joglar JM, Martus JE, Nesiama JO, Pahys JM, Rathjen KE, Riccio AI, Schulz JF, Stans AA, Shah MI, Warner WC Jr, Yaszay B. Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group. J Bone Joint Surg Am. 2019;101(1):e1.
- 11. Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-2284.
- 12. Copley PC, Tilliridou V, Kirby A, Jones J, Kandasamy J. Management of cervical spine trauma in children. Eur J Trauma Emerg Surg. 2019;45(5):777-789
- 13. Geuther M, Grassner L, Mach O, Klein B, Högel F, Voth M, Bühren V, Maier D, Abel R, Weidner N, Rupp R, Fürstenberg CH; EMSCI study group, Schneidmueller D. Functional outcome after traumatic cervical spinal cord injury is superior in adolescents compared to adults. Eur J Paediatr Neurol. 2019;23(2):248-253.