Differences Between Adults and Children
The anatomy and relationships of the child’s cervical spine is different to that in adults [4]:
- Children have relatively larger heads
- Their ligaments and joint capsules are more lax
- Their facet joints are more horizontal
- Their vertebral bodes are wedge shaped
This has the following consequences:
- Pseudosubluxation (the appearance of forward slippage of one vertebral body on another); pseudosubluxation of C2 on C3 occurs in 24% of under 8 year olds and of C3 on C4 in14% of under 8 year olds (click on the x-ray to enlarge)
- SCIWORA (Spinal Cord Injury without radiological abnormality) which is defined as “objective signs of myelopathy as a result of trauma with no evidence of fracture or ligamentous instability on plain radiographs or tomography”. It is more common in children and is reported to occur in up to 30% of spinal cord injuries in children
Younger children (<10 yrs) are also more likely than older children to:
- Injure the upper cervical spine (C1-C4) compared with lower c-spine
- Dislocate the cervical spine
- Injure the spinal cord itself
The cervical spine takes on its adult form from about the age of 8 years.
Learning bite
The cervical spine in children is anatomically different to that in adults and this results in different patterns of injury.