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Verletzungen der BWS und LWS bei Kindern unter 16 Jahre – Versorgungsrealität im deutschsprachigen Raum: eine Registerstudie

  • Hauke Rüther,
  • Saleh Alayesh,
  • Christoph-E. Heyde,
  • Dina Wiersbicki,
  • Yasmin Youssef,
  • Julia Bolte,
  • Pia Brecht,
  • Alexander Carl Disch,
  • Jan-Sven Jarvers

摘要

Background

Spinal injuries in childhood are rare. There are few meaningful data for German-speaking countries.

Questions/aim of the study

Evaluation of the registry data of the German Spine Society (DWG) with respect to the reality of care for thoracolumbar injuries in childhood.

Material and methods

This retrospective study was initiated by the Spinal Trauma in Childhood Working Group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery (DGOU). All patients under the age of 16 years who underwent surgery between 1 January 2017 and 31 June 2023 were included. An anonymized evaluation of the demographic data was carried out with respect to age, gender, level of injury, neurological impairment, classification and treatment performed with intraoperative and postoperative complications. The specified documentation in the spine register served as the information basis. Regarding age classification 3 groups were used: I: 0–6 years, II: 7–9 years, III: 10–16 years.

Results

Data from 83 children with 150 injuries in the thoracic and lumbar spine areas with a mean age of 11.4 (± 3.45) years were analyzed. A total of 78 (52%) thoracic and 72 (48%) lumbar injuries were found. Type A injuries were most common (n = 89; 59.2%). Type B injuries were found in 32.2% (n = 48) and occurred mainly in group III. According to the AO neurological injury classification 18 (21%) patients had incomplete and 4 (4.8%) patients had complete paraplegia. Various methods were used for surgical treatment, the most common being dorsal stabilization (n = 73; 87.9%). The majority of operations were uncomplicated (n = 75; 90.4%).

Discussion

According to the registry data 83 children were treated surgically with an acceptable complication rate. Older children and adolescents (group III) had a significantly higher injury severity compared to younger children. As with most registry studies, only limited conclusions can be drawn about surgical strategies, indications and techniques.