Evidence map›Paper›PMID 38852115›Full record

Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024

Epidemiology of pediatric spinal trauma with neurological deficits in Catalonia: a 36-year experience.

Alejandro García-Rudolph, Mark Andrew Wright, Nicolas Rivas, Eloy Opisso, Joan Vidal

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alejandro García-RudolphDepartment of Research and Innovation, Institut Guttmann - Hospital de Neurorehabilitació, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n, 08916, Badalona, Barcelona, Spain. alejandropablogarcia@gmail.com.ORCID http://orcid.org/0000-0003-0853-8334
Mark Andrew WrightDepartment of Research and Innovation, Institut Guttmann - Hospital de Neurorehabilitació, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n, 08916, Badalona, Barcelona, Spain.
Nicolas RivasDepartment of Research and Innovation, Institut Guttmann - Hospital de Neurorehabilitació, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n, 08916, Badalona, Barcelona, Spain.
Eloy OpissoDepartment of Research and Innovation, Institut Guttmann - Hospital de Neurorehabilitació, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n, 08916, Badalona, Barcelona, Spain.
Joan VidalDepartment of Research and Innovation, Institut Guttmann - Hospital de Neurorehabilitació, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n, 08916, Badalona, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeExisting literature on pediatric traumatic spinal cord injury (PTSCI) demonstrates large variations in characteristics, incidence, time-periods and etiology, worldwide. Epidemiological studies addressing injuries to the total spine, conducted in Southern European regions are remarkably scarce; therefore we aimed to investigate long-term trends analyzing etiology, fracture location and type, single or multiple fractures, associated lesions and neurological status in Catalonia, Spain.

methodsWe conducted a retrospective observational study. We analyzed post-acute patients after PTSCI, aged 0-17, admitted with neurological deficits between 1986 and 2022 to a specialized hospital in Catalonia. Neurological deficits were assessed using the American Spinal Injury Association Impairment Scale (AIS).

resultsTwo hundred and forty nine children were included, 174 (69.9%) boys and 75 (30.1%) girls; mean age was 13.9 years (range, 2 months to 17 years). Two hundred and four children (82%) had ≥ 1 spinal fractures, 66 (26.5%) dislocations and 8 (3.2%) SCIWORA. Fractures were multilevel contiguous in 108 (43.4%) cases. Fracture types comprised 81 vertebral compactions (32.5%), 22 burst fractures (8.8%), 7 odontoid (2.8%) and 4 tear-drops (1.6%). There were ≥ 1 associated lesions in 112 cases (45%): in limbs in 23 cases (9.2%), thorax or abdomen in 59 (23.7%) and skull or face in 81 (32.5%). In 44 cases (39% of the 112) there were multiple lesions. Locations comprised cervical spine in 105 cases (42%), thoracic spine in 124 (49%), lumbar spine in 18 (7%), and sacrum in 2 (0.8%). Road traffic accidents (RTAs) were the main etiology (62.2%) over the whole period. However, from 2016 onwards, RTAs dropped below the rate of falls and sports injuries. The most common sites for injury in those aged 9 years or older were in the cervical (41.1%) and thoracic (50.7%) regions. Those aged 8 or under were far more likely to sustain a complete SCI (80.0%) or an accompanying traumatic brain injury (45.0%) likely due to higher numbers of pedestrian versus car RTAs. A significant peak in the occurrence of cases during 2006-2010 (20.1%) was identified with an absolute drop immediately after, during 2011-2015 (8.8%). A marked shift in trend is observed between 2016-2022 regarding age of injuries (an increase in 9 years or older), etiology (increase in falls and sports versus RTA), AIS grade (increase in incomplete lesions AIS B-D versus AIS A), severity (increase in tetraplegia versus paraplegia) and location (increase in cervical versus lumbar and thoracic injuries).

conclusionsA shift in trend is observed in the past 7 years regarding age of injuries (increase in those older than 9), etiology (increase in falls and sports versus RTA), AIS grade (increase in incomplete lesions AIS B-D versus AIS A), severity (increase in tetraplegia versus paraplegia) and location (increase in cervical). LEVEL OF EVIDENCE: IV.

Indexed as

Spinal Cord InjuriesSpinal FracturesAdolescentChildChild, PreschoolFemaleHumansIncidenceInfantMaleRetrospective StudiesSpainSpinal InjuriesAdolescentsChildrenEpidemiologyPediatricSpinal cord injury

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.