Pediatric Cervical spine fracture in 31 month old girl: Case
The index case is a 31-month-old, 15kg, 91cm, and previously healthy girl who was involved in a motor vehicle collision (MVC). She was a rear seat passenger in a forward-facing restraint system that supported rear-facing restraint up to 18 kg and 74 cm. Vehicle was involved in a T-bone collision at highway speeds with another stationary vehicle. Due to the nature of the impact, she was placed in a cervical collar on site.

Patient did not experience loss of consciousness, but on admission was notably lethargic. Physical examination revealed a large frontal scalp laceration and abrasions congruent with seatbelt injuries but overall, no neurological deficits or weakness. Computed tomography of the cervical spine showed a fracture of the body of C2 through the growth plate with subluxation of the dens onto the body of the C2 vertebra.

Treatment of the odontoid fracture was by closed reduction and application of a pediatric halo-vest device intraoperatively, under general anesthesia. Following her procedure, she remained stable and was able to mobilize, and was discharged from the hospital.

One month post-operatively, because she recovered well and there was no radiographic evidence of residual translation or subluxation to the cervical spine, her halo device was removed. She was placed in a cervical collar following the procedure and remained in stable condition.