Neurospine.  2020 Dec;17(4):797-808. 10.14245/ns.2040404.202.

Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations

Affiliations
  • 1Burdenko Institute Department of Neurosurgery, Moscow, Russian Federation
  • 2Department of Neurosurgery, Belfast Health and Social Care Trust, Northern Ireland, Belfast, UK
  • 3Department of Neurosurgery, Ege University, Izmir, Turkey
  • 4Neurosurgery Liaquat National Hospital & Medical College, Karachi Pakistan, Karachi, Pakistan
  • 5Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation

Abstract

Cervical trauma in children have variations from the adults mainly due to anatomic differences. An optimal diagnostic and treatment strategy is critical, particularly when there is a lack of standardized protocols for the management of such cases. This review paper examines the diagnostic and treatment options of pediatric cervical trauma and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA). A literature search for the last 10 years were conducted using key words. Case reports, experimental studies, papers other than English language were excluded. Up-to-date information on pediatric cervical trauma and SCIWORA were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of WFNS Spine Committee. The statements were voted and reached a consensus using Delphi method. This review reflects different aspects of contemporary pediatric cervical trauma decision-making and treatment, and SCIWORA. The mainstay of SCIWORA treatment is nonsurgical with immobilization, avoidance of risky activities. Prognosis generally depends on the initial neurological status and magnetic resonance imaging. Due to a significant discrepancy in the literature on diagnostic and management, future randomized controlled trials are needed to aid in generating standardized protocols.

Keyword

Cervical spine; Spinal cord injury; Pediatric trauma; Spinal cord injury without radiographic abnormality
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