Traumatic Cervical Spine Injury in Children and Adolescents Requiring Neurosurgical Intensive Care: A Seven-Year Retrospective Descriptive Cohort

Abstract

Traumatic cervical spine injury in children and adolescents is uncommon but may cause major disability and prolonged critical care. This retrospective descriptive cohort characterizes patients aged 18 years or younger admitted to the Neurosurgical Intensive Care Unit (ICU) of a tertiary trauma center in New Delhi, India, during 2008–2015. Discharge status was classified as favorable (American Spinal Injury Association [ASIA] Impairment Scale D–E) or unfavorable (ASIA A–C or in-hospital death). We used chi-square tests with Yates’ continuity correction, with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Among 112 patients, 83.0% were male, 85.7% were aged 9–18 years, and 77.7% had spinal canal compromise. Forty-seven patients (42.0%) had favorable and 65 (58.0%) had unfavorable discharge status, including nine in-hospital deaths (8.0%). Favorable status was associated with absence of spinal canal compromise (OR 6.67, 95% CI 2.40–18.54) and absence of the composite ICU complication indicator (OR 6.44, 95% CI 2.61–15.93), and with fracture rather than subluxation, absence of tracheostomy, and favorable admission ASIA category. No multivariable adjustment was performed; these exploratory, unadjusted associations do not establish independent or causal effects. The cohort provides descriptive data from an under-reported tertiary trauma setting and identifies variables for prospective multicenter study.