Epidemiology of spinal cord injury without radiographic abnormality in children: A nationwide perspective

Abstract

PurposeTo characterize the epidemiology and costs associated with spinal cord injury without radiographic abnormality (SCIWORA) based on patient age.MethodsAn analysis of data complied for 2012 in the Healthcare Utilization Project KID database (HCUP-KID), which represents a nationwide database of pediatric admissions, was performed. An initial search identified all children diagnosed with SCIWORA based on International Classification of Diseases, 9th edition (ICD-9) codes. Only data on patients aged <18 years were included in the analysis. The associated codes were then searched to identify the cause of injury. Pertinent epidemiologic data were collected from the database, including age, gender, and racial group. Injury level and pattern were determined from the associated ICD-9 codes, as were associated injuries. Hospital data included length of stay, in-hospital mortality, total hospital charges, and primary payer. All data were compiled and stratified based on patient age into three groups: group 1, age 0–3 years; group 2, age 4–10 years; group 3, age 11–17 years. These data were compared using Student’s t test and Chi-squared analyses.ResultsA total of 297 patients were identified who met the inclusion criteria. There was a slight predominance of females among the youngest patients (53 %) with a significant dominance of males in the oldest group (72 %) (p < 0.001). The most common race among the patients studied was white (50 %) followed by Hispanic (14 %), Black (12 %), Asian/Pacific Islander (4 %), and Native American (1 %). Overall, the most common cause of injury was sports injuries, which were responsible for 122/297 (41 %) injuries, followed by motor vehicle collisions (26 %). Mechanisms of injury were significantly varied based on age group, with motor vehicle collisions the most common cause in the youngest two age groups and sports injuries the most common in the oldest age group (p < 0.05). The most common location injured was the cervical spine (46 %), with the upper cervical spine most commonly injured, particularly in the younger age groups. Additional injuries were found in 158/297 (53 %) of patients, and these were more common among younger patients. Head trauma was the most common associated injury in all age groups, but the highest rate was found the youngest age groups (p < 0.0001). The average hospital stay for all patients was 13 days, with longer stays seen in younger age groups (p < 0.05). In-hospital mortality was uncommon among these patients and occurred in only 6/297 (2 %) of patients. Hospital charges were highest in the younger age groups, with an average charge of $210,772 for those in the youngest age group, decreasing to $72,178 for those in group 3 (p < 0.0005). The most common payer was public insurance/medicaid in the youngest age group and private insurance in groups 2 and 3 (p < 0.0001).ConclusionsSCIWORA is an uncommon but potentially devastating injury in children. As with many pediatric injuries, this injury is heterogeneous between children of differing ages. This anal...

Epidemiology of worldwide spinal cord injury: a literature review

“…30,41 Nearly all the sporting accidents resulting in SCI occurred in younger patients. 34,42 In the increasingly stringent social security, the occurrence of violence was declining year by year. 36,40 At the same time, iatrogenic SCI still cannot be ignored.…”

Traumatic Tetraplegia without Radiologic Abnormalities in an Elderly Woman: A Case Report

“…In the present case hyperextension injury may lead spinal cord injury. Besides, cervical spondylosis leads to spinal cord injury (10,11) degenerative changes in spine in the present case may have led to tetraplegia. In this case, we think that spinal cord injury is caused by degenerative changes.…”

“…MRI helps identify spinal cord parenchymal abnormalities and ligamentous disruptions. Cord concussion, edema, contusion, and transection are the forms of parenchymal cord injuries (8,10). The presented case had poorer prognosis despite normal MRI findings except herniated discs and degenerative changes.…”

Cervical Spine Evaluation in Pediatric Trauma: A Review and an Update of Current Concepts

“…Majority of the pediatric cervical spine injuries (CSIs) occur between the skull and C4 vertebra; and around 10.8% to 38.7% of these injuries involve C1 and C2 vertebrae. 1 9 10 11 Children suffer from atlanto-axial injuries 2.5 times more often than adults. 12 As per available western data, the most common variable (in 67.7%) associated with pediatric CSIs includes noncompliance with seat belt.…”