Children are not just miniature adults, especially when it comes to the spine and any kind of surgery in that area.
“While much of the surgical treatments given to injured adults can be adapted to children, their unique anatomy and function needs special consideration,” says Dr. Richard Anderson, neurosurgeon at The Spine Hospital at the Neurological Institute of New York. “This is particularly true in the cervical spine [neck].”
Of course, the most obvious difference between an adult’s and a child’s spine is size. The younger the child; the smaller the spine. But, according to Dr. Anderson, that is not the least of it.
The soft tissues in the spine, including ligaments and joint coverings, are more elastic. The disc that sits between the bones of the spine is more expansive, allowing more distraction and greater range of motion. Some of the bones are smaller and joints more shallow, making the bones less locked together.
The vertebral bodies are anteriorly wedge-shaped and have not completely formed, so they can also separate more easily from their end plates. Additionally, this less stable spine has to support an oversized head using underdeveloped neck muscles.
Taking all of this into consideration, with the same forces applied, a child’s neck is likely to be more injured than an adult’s in any given situation. Dr. Anderson says he routinely sees neck injuries in children that are caused by sports and automobile accidents.
The most common injuries to the upper part of the spine in older children include dislocations, ligament injuries, and compression fractures. Though perhaps less frequently, these are all types of injuries seen in adults, too. But repairing them in children takes a whole set of adaptations and understanding of the unique spinal anatomy of children.
Dr. Anderson says there are special surgical techniques and hardware that are especially suited to the pediatric spine. Another consideration with children is the length of follow-up time. Dr. Anderson recommends at least yearly follow-up until the child’s spine has fully matured.
Dr. Anderson regularly shares his expertise with other neurosurgeons and orthopaedic surgeons across the globe. His aim is always to directly improve the lives of his own patients, and through his teaching, the lives of children worldwide.
Originally posted on May 10, 2010
Updated on Nov 18, 2016
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