Distribution of C Spine Injuries
Younger children tend to have higher proportion of upper
cervical spine injuries (C1–C4) due to the higher fulcrum of
the immature spine, dislocations instead of fractures, and
spinal cord injury without radiographic abnormality
(SCIWORA).

Mechanism of injury also varies by age.
In 0-2 years, Nonaccidental trauma and MVC
In older children sports-related injuries and  motor vehicle
collisions.

The ABCS of cervical spine radiograph interpretation
A - Alignment - curves, malalignment, subluxation and    
    distraction.
B - Bone - fractures, anterior and posterior vertebral column
    and ossification centre
C - Cartilage - Intervertebral disc space, ossification centres
S - Soft Tissue - prevertebral and predental space.
                           ( prevertebral space at C3 should be 1/2 to  
                            2/3 of AP Width of adjacent vertebrae)

Specific Injuries
Jefferson fracture
- bursting fracture of the ring of C1 as a
result of an axial load.
Hangman’s fracture - traumatic spondylolisthesis of C2.
This injury occurs as a result of hyperextension, which
fractures the posterior elements of C2.
Atlantoaxial (AA) subluxation - result of movement between
C1 and C2 secondary to transverse ligament rupture or a
fractured dens
Vertebral compression injuries - isolated anterior wedging,
teardrop fractures, or burst vertebral bodies
SCIWORA < 8 years age who present with, or develop
symptoms consistent with, cervical cord injuries without any
radiographic or tomographic evidence of bony abnormality
Cervical Spine Injury
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