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To analyze cervical spine injuries resulting from recreational activity in shallow ocean water amid high-energy breaking waves. Single-center 10-year review of patients who sustained cervical injuries at the beach in Long Island, New York, USA. A systematic review following the PRISMA guidelines was also performed. Nineteen patients (age 17–79 years) sustained cervical injury from high-energy breaking waves while in shallow beach water. Six patients dived into a wave; 6 patients were struck by a large wave while standing upright; and 7 tumbled in the waves while engaged in nonspecified recreational activity. All 7 patients with subaxial cervical AO Spine Injury Score (AO-SIS) >10 had cervical spine injury with cord signal change and required operative management. Diving mechanism, AO-SIS >10, and cord signal change all predicted significant disability or death at 12 months (P < 0.01). The present study and 7 additional studies reporting on 534 patients (mean age, 45.4 years) were analyzed. Within the reported literature, most patients (94.2%) sustained a spinal cord injury. On long-term follow-up, an estimated 64.8% of patients had permanent neurologic injury and 12.5% had permanent quadriplegia. We offer the first description of cervical injuries sustained in water-related recreational activity using the AO-SIS. The morphology of injuries varied significantly and seemed to depend on body position and wave kinetic energy. Patients presenting with cervical injury in this setting and yielding AO-SIS >10 are likely to have poor functional recovery. [ABSTRACT FROM AUTHOR]

Kyphoplasty is commonly employed in the treatment of compression fractures in the elderly and is increasingly used in the treatment of adult trauma along with concomitant instrumentation. Although kyphoplasty with instrumentation has been reported in pediatric patients, concerns regarding retardation of spinal growth and iatrogenic spinal deformity have been raised. The utilization of kyphoplasty without instrumentation has yet to be reported in the case of pediatric patients. A 13-year-old male presented to the emergency department with a traumatic L2 burst fracture with 50% loss of height, which continued to cause severe pain after a trial of bracing. He was subsequently treated with a kyphoplasty without instrumentation. He experienced a rapid and excellent recovery and resumed all previous activity. Kyphoplasty alone without instrumentation is a less invasive means to treat these patients and also prevents iatrogenic deformity or retardation of growth in the pediatric spine. [ABSTRACT FROM AUTHOR]