Abstract
Introduction: There is a paucity of published data concerning major thoracolumbar spine trauma in the paediatric population, reflecting the rarity of these injuries.
Aim: To review retrospectively 11 cases of thoracolumbar paediatric spinal fractures and dislocations requiring operative management by one surgeon from 1991 to 2001 at Starship Children’s Hospital.
Methods and results: The mean age was 10 years (range: four to 15). Four patients had a neurological deficit (three were incomplete, one was complete). All patients underwent surgery with internal fixation. Canal decompression was achieved by operative realignment in most patients although two patients underwent additional decompression by corpectomy. Seven patients had flexion-distraction injuries with facet joint dislocations. These patients were treated with posterior instrumentations in compression. A further two patients with fracture-dislocations were also treated by posterior instrumentation and the remaining two patients (one burst fracture and one fracture-dislocation) by anterior instrumentation. The general principles for surgical management of thoracolumbar spine trauma in adults were found to be applicable to the children in this series. Suitably sized internal fixation devices were available to allow stabilisation in all cases. The preponderance of dislocations presumably reflects differing biomechanics in the immature versus the adult spine and necessitated a posterior operative approach in most cases.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
