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Incidence of Spinal and Spinal Cord Injuries and Their Surgical Treatment in Children and Adolescents: A Population-Based Study

Puisto, Ville MD*†; Kääriäinen, Sakari MSc; Impinen, Antti MSc; Parkkila, Timo MD, PhD*; Vartiainen, Erkki MD, PhD; Jalanko, Tuomas BM*; Pakarinen, Mikko P. MD, PhD*; Helenius, Ilkka MD, PhD*‡

doi: 10.1097/BRS.0b013e3181c64423
Health Services Research

Study Design. A population based, epidemiological study.

Objective. To investigate incidence of spinal and spinal cord injuries and their surgical treatment in children and adolescents in Finland.

Summary of Background Data. Epidemiological data on spinal injuries and their treatment in children is sparse.

Methods. All spinal and spinal cord injuries in children under 18 years of age treated in hospital between 1997 and 2006 in Finland were included. The data on injuries, hospitalizations, and surgical treatment were collected from the National Hospital Discharge Register which includes all in-patient treatment episodes. Fatal spinal injuries were derived from the Official Cause-of-Death Statistics of Finland.

Results. The overall incidence of spinal injuries remained stable during the follow-up period, averaging 66 per 106 of the reference population aged below 18 years. The proportions of cervical, thoracic, and lumbar spine injuries altered with age: 64% of spinal injuries in children below 8 years of age were cervical, while in the older children lumbar (42%) and thoracic spine injuries (33%) were more common than cervical. The incidence of spinal cord injuries averaged 1.9 per 106 children. Thirty percent of the children with spinal injury underwent surgery. The annual incidence of fatal spinal injury averaged 2.4 per 106 children.

Conclusion. Pediatric spinal and spinal cord injuries are rare. In contrast to previous literature, the most commonly affected area is lumbar spine. One-third of the children with spinal injury underwent surgery.

The annual incidence of pediatric spinal injuries averaged 66 per 106 in this population-based epidemiological study. Most commonly affected area in children below 8 years was cervical spine, while in older children most fractures occurred in lumbar and thoracic spine. One-third of the children with spinal injury underwent surgery.

From the *Section of Pediatric Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland; †National Institute for Health and Welfare, Helsinki, Finland; and ‡Turku University Hospital, Section of Pediatric Surgery, Finland.

Acknowledgment date: November 25, 2008. Revision date: March 12, 2009. Acceptance date: May 4, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional and foundation funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by Pediatric Research Foundation, Finland and Medtronic International and Baxter Finland.

National Research and Development Center for Welfare and Health, Helsinki and Statistics Finland have provided additional data for this study.

Address correspondence and reprint requests to Ville Puisto, MD, Toini Muonan Katu 8 A 20, PO Box FIN-00560, Helsinki, Finland; E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.