Traumatic spine injuries in paediatric and adolescent patients: a registry-based study of ICU needs and clinical outcomes

BACKGROUND: Traumatic spine injuries (TSIs) in paediatric and adolescent populations are uncommon but often result in serious morbidity and healthcare burden. In Saudi Arabia, limited population-based data exist to describe the epidemiology and outcomes of TSIs in this group. METHODS: This retrospective cohort study included patients aged 1-18 years with TSIs admitted to King Saud Medical City in Riyadh between August 1, 2017, and December 31, 2022. Data were extracted from the Saudi TraumA Registry (STAR). Patients were categorised into three groups: pre-school (1-6 years), school-age (7-12 years), and adolescents (13-18 years). Demographic, injury, and outcome variables were analysed using descriptive and comparative statistics. RESULTS: A total of 353 patients were included, with males comprising 84.7%. Motor vehicle crashes (MVCs) were the leading cause of injury (69.3%). Overall, thoracic spine injuries were most common (43.8%), while high cervical injuries predominated in pre-school children (40.8%). Polytrauma occurred in 72.5% of cases, and a third of the patients required ICU admission. Among those admitted to ICU or who died, head injuries were the most frequent associated injury. Common procedures included spinal internal fixation (25%), craniotomy/craniectomy (20%), and lower-limb fixation (19.5%). Mechanical ventilation was required in 23.8% of patients, and in-hospital mortality was 3.4%. Mortality was associated with higher Injury Severity Scores, lower Glasgow Coma Scale, and increased need for trauma team activation, blood transfusion, and respiratory support. CONCLUSION: This study highlights the burden of TSIs among children and adolescents in Saudi Arabia, particularly those caused by MVCs and frequently associated with polytrauma. The findings highlight the pressing need for targeted prevention strategies, improved trauma system infrastructure, and multidisciplinary management. Future research should investigate long-term outcomes and evaluate the effectiveness of preventive initiatives.