Comparison of cervical versus thoracic spinal cord injury outcomes in pediatric trauma patients

Pediatric Surgery International, 2025 · DOI: https://doi.org/10.1007/s00383-024-05933-4 · Published: December 9, 2025

Simple Explanation

This study compares cervical and thoracic spinal cord injuries (SCI) in pediatric trauma patients (PTPs) to see if the location of the injury affects outcomes like mortality and length of hospital stay. Researchers analyzed data from a national trauma database, looking at patients 17 years old or younger who had either cervical or thoracic SCI. The study found that cervical SCI was associated with higher mortality, while thoracic SCI was associated with higher injury severity scores and longer hospital stays.

Study Duration

2017–2021

Participants

5280 PTPs ≤ 17 years-old with cervical or thoracic SCI

Evidence Level

Not specified

Key Findings

1
PTPs with cervical SCI have higher mortality while those with thoracic SCI have higher ISS and hospital LOS.
2
Cervical SCI were associated with a fourfold higher risk of death.
3
MVC was the most common cause of injury, and both groups had high rates of positive drug screens.

Research Summary

This retrospective national database review demonstrated that falls more commonly resulted in cervical SCI than thoracic SCI, while MVCs, gunshot wounds, auto vs pedestrian, and motorcycle collisions more often led to thoracic SCI. Furthermore, substance and alcohol use were more common in children with thoracic SCI. Finally, this study demonstrated higher mortality and ventilator days for children with cervical SCI, however children with thoracic SCI had higher overall injury burden (e.g., ISS) and hospital LOS.

Practical Implications

Prognostication

Understanding the differing outcomes between cervical and thoracic SCI may assist providers with prognostication.

Injury Prevention

The findings highlight the need for enhanced injury prevention strategies, especially encouraging safe driving practices among parents.

Future Research

Further studies are needed to evaluate differences in long-term outcomes and improve treatment and quality of life for children with SCI.

Study Limitations

1
Missing data, coding errors, and misclassification.
2
Children with severe injuries that did not survive to hospitalization were not included in the TQIP database.
3
The TQIP database lacks granular data related to the severity of the SCI including the American Spinal Injury Association (ASIA) classification.

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