Trends in Pediatric Sports-Related Cervical Spine Trauma: A 15-Year Analysis (2006-2019)

Introduction: Sports-related cervical spine injuries (CSI) in pediatric populations are becoming increasingly concerning, particularly due to their association with spinal cord injury (SCI) and traumatic brain injury (TBI). While youth sports participation has grown, data from large databases on sports-related cervical trauma trends over time remain sparse.

Methods: The Kids' Inpatient Database (KID) was used to query pediatric patients who sustained cervical spine injuries due to sports between 2006 and 2019. Patients were grouped by injury type, including C1-4 and C5-7 fractures, dislocations, and SCI without radiographic abnormalities (SCIWORA). Age categories were divided into children (4-9), pre-adolescents (10-13), and adolescents (14-17). Kruskal-Wallis and Mann-Whitney U tests were used to identify differences across age groups and sports, while logistic regression was employed to predict TBI and cervical injury types.

Results: A total of 42,700 patients were identified across the study period, with adolescents consistently presenting the highest rate of cervical spine injuries across all injury types. From 2006 to 2019, football injuries increased significantly, from 5.9% in 2006 to 11.3% in 2019, correlating with a higher incidence of SCIWORA (P < 0.05). Adolescents were 3-7× more likely to sustain fractures, dislocations, and SCI than younger children (P < 0.001). The odds of concurrent TBI were highest in adolescents, rising from 52% in 2006 to 61.2% in 2019. SCIWORA was a significant predictor of concurrent TBI across all sports (OR=2.45, P< 0.001).

Conclusion : Adolescents remain the most vulnerable to severe cervical spine injuries and associated complications such as SCI and TBI. The rise in football-related injuries highlights the need for enhanced safety regulations. Recognizing age- and sport-specific risks can inform preventative strategies to protect youth athletes.