Dr. Khaled Almansoori, MD, M.Ed, FRCSC, Adult & Paediatric Spine Surgeon, Department of Orthopaedic Surgery, Advocate Christ Medical Center,
Illinois, USA.

Abstract
Due to the distinctive anatomic and biomechanical features of the growing paediatric spine, children are susceptible to unique patterns of spinal injuries. Although clinical examination can help guide management, physicians are often required to rely on advanced imaging. Imaging interpretation can be challenging when considering that abnormal parameters among adults, are often within normal physiological limits in children. In general, spinal injuries in children younger than nine years of age are often managed non-operatively, while adolescents are typically managed by adult treatment principles. With the exception of neurologic injuries, most paediatric spinal injuries demonstrate good to excellent prognosis and outcomes.
Key Words: fracture, injury, spine, paediatric, children.

Epidemiology
Paediatric spine injuries account for 2% to 5% of all hospital admissions, and represent less than 2% of paediatric fractures.¹ The annual incidence of hospitalizations is approximately 100 per million and there is a decreasing trend in the annual incidence.² Cervical spine injuries are the most common area of involvement accounting for 47-80% of all paediatric spinal injuries, followed by lumbar and thoracic injuries.^3,4 Due to the greater head-torso ratio in younger children, weaker cervical musculature, and multiple synchondroses, the majority of cervical spine traumas occur within the C1-3 vertebral levels in children less than eight years of age.³ Motor vehicle accidents contribute to over half of all hospitalizations with sports injuries (27%) and falls (15%) contributing to a greater proportion among adolescents.^3,5 Up to 3% of paediatric spinal injuries are due to non-accidental trauma with the vast majority occurring in toddlers and infants with an average presentation of five months of age.^3,6,7