Which region is most commonly injured in neonatal spinal trauma during birth?

• A. Lower cervical
• B. Thoracic
• C. Upper cervical
• D. Lumbar

Answer: (C)

Birth-related spinal trauma in newborns most often affects the upper cervical spine, especially the atlas–axis region. During delivery, the head undergoes rapid flexion/extension and rotation, often with traction placed on the neck. The neonate’s head is large relative to the neck, and the ligaments at the craniovertebral junction are relatively lax, making the C1–C2 area particularly vulnerable to distraction and subluxation during difficult extractions or instrumental deliveries. The mid to lower spine is less commonly injured because these regions are less subjected to the same extreme forces during passage through the birth canal.