Child Abuse Research Today is a free monthly online journal that collates and summarizes the latest research about Child Abuse, including details on family violence, examinations, long-term effects, psychiatrics disorders.

Spinal fracture through the neurocentral synchondrosis in battered children: a report of three cases.

Vialle R, Mary P, Schmider L, le Pointe HD, Damsin JP, Filipe G

Department of Paediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris VI, Paris, France. ravialle@noos.fr

STUDY DESIGN: Retrospective case series. OBJECTIVE: To report 3 cases of unusual spinal fracture through the neurocentral synchondrosis. SUMMARY OF BACKGROUND DATA: Traumatic lesions of the spine or spinal cord due to physical abuse are rare. We report 3 cases of vertebral fractures involving the neurocentral synchondrosis in battered children. METHODS: The medical data of the 3 cases were retrospectively reviewed. We discuss the pathomechanism and treatment strategies. RESULTS: In 2 cases, the vertebral body was displaced anteriorly and, in 1 case, posteriorly, all without neurologic compromise. The lateral radiographs showed vertebral displacement, but the diagnosis could be suspected on frontal views because of interpedicular distance widening. Treatment was nonoperative with bracing in 2 cases. In the third case, a posterior epiphysiodesis was done to avoid development of progressive kyphosis of the injured spine. One child treated nonoperatively died from other traumatic lesions associated with the physical abuse. In the 2 other cases, outcome was good with a well-balanced spine in 1 case and a moderate, well-tolerated kyphosis in the other case. CONCLUSIONS: Such spinal lesions are rare but could be conservatively treated in case of anterior vertebral displacement without vertebral endplate impairment. A posterior displacement of vertebral body could be responsible for a neurologic compromise.

Published 11 May 2006 in Spine, 31(11): E345-9.
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