ABSTRACT
Spinal injuries are rare in children, and are usually associated with high-impact injury mechanisms such as a pedestrian hit by a car. Although serious injury is rare, minor injury to the neck and back is common, and it is important to feel secure in assessing severity. Thoracic and lumbar fractures are also uncommon in childhood. Typical mechanisms would include falling from a height, or a vehicle crash without an appropriate seat-belt. Cervical spinal immobilisation in practice is difficult in children, and is managed differently around the world. Dislocation of the ligaments can occur in the cervical spine, and usually involves the upper three vertebrae in young children, and the C7/T1 junction in older children. Adolescents present with back pain symptoms more frequently than younger children. The conditions most often responsible, such as Scheuermann's disease and spondylolysis/spondylolisthesis, usually present with insidious onset or chronic symptoms.
