Advanced Research Of Pediatric And Adolescent Thoracolumbar Spine Trauma

The incidence of thoracolumbar spinal trauma in pediatric and adolescent is low.But the results of misdiagnosis and therapeutic error are very serious.And it should be deserved attention by orthopedic surgeons.Because of the anatomy,injury pattern,radiographic findings and clinical manifestations are different from adults,so the management of pediatric and adolescent thoracolumbar spine trauma is in a much different and should be warranted special consideration.The spinal anatomical structure of pediatric and adolescent has unique characteristics because of the spine is still in the process of growth and development.Compared with the adult spine,the resistance to deformation ability and the bone elastic modulus are stronger because the organic matter is more than inanimate matter.Additionally the ligaments and surrounding soft tissue are more pliable than adults.Therefore,pediatric and adolescent thoracolumbar spinal have greater elasticity and compressibility than adults.In particular,Spinal Cord Injury without Radiographic Abnormality(SCIWORA),fracture of the ring apophysis and epiphyseal plate injury of vertebral body are unique to pediatric and adolescent.All of them have unique damage characteristics,diagnosis and treatment.They are the main types of injury to distinguish between adult spinal trauma.At present,there is no unified international standard for clinical treatment of pediatric and adolescent thoracolumbar spinal trauma.Most scholars believe that the vast majority of pediatric and adolescent can take conservative treatment of thoracolumbar spine trauma.It can achieve satisfactory results by wearing TLSO(Thorax Lumbar Sacrum Orthosis)and bed rest.When the thoracolumbar spine trauma combined with spinal instability,severe kyphosis or serious spinal nervous system injury,surgical treatment is required.The principle and method of surgical treatment are similar to adults,including spinal decompression,fracture reduction,internal fixation and interbody fusion.Since pediatric and adolescent are at the peak of growth and development,posterior short segment fixation is the main surgical treatment.The risk of progressive spinal deformity increased after pediatric and adolescent spinal cord injury.So the follow-up time should be until the epiphyseal closed.