High Rates of Neurological Improvement Following Severe Traumatic Pediatric Spinal Cord Injury

Wang, Michael Y.; Hoh, Daniel J.; Leary, S.; Griffith, Pamela; McComb, J. Gordon

doi:10.1097/01.brs.0000129026.03194.0f

Cited by 87 publications

(47 citation statements)

References 17 publications

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“…When sensory and motor score were evaluated we found improvement in motor score in 51.14% and sensory score in 76.19% of cases. These findings of our study are consistent with other literatures that the recoveries of neurologic function after severe traumatic spinal injuries occur with a significantly greater incidence in children 20 .…”

Section: Observations and Discussionsupporting

confidence: 83%

“…It reflect that better improvement found in children as compare to adult. 20 Neurological evaluation was possible in 21 prospective cases in which follow up was possible it was done by using ASIA impairment scale and grading system and KGMU grading system in toddler one grade A improve to grade-D at last follow up, in school going four patient of grade-A remain grade-A and 1 case of grade-D improve to grade-E. In adolescent out of 7 grade-A at admission 6 remain grade A, one improve to grade-B, 4 cases out of 6 grade-D improve to grade-E.…”

Section: Observations and Discussionmentioning

confidence: 99%

“…After severe traumatic spinal cord injury the incidence of recovery of neurologic function is greater in children than adult and this occurs over a prolonged post injury period. 20 …”

Section: Introductionmentioning

confidence: 99%

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A retrospective and prospective study of spinal injuries in children and adolescent- incidence etiology and early outcome

Krishna¹

2012

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Background-Traumatic spinal injuries in children consists up to 10% of all reported spinal injuries. The true incidence may be underestimated because of mortality at the site or during transport. The level of injury and incidence of neurological compromise varies with the age of child. The infants, toddlers, school age children and adolescents have distinctive anatomic and biomechanical spinal features and behavioral patterns that distinguish them not only from adults but also from each other in this study we analyses all parameter of differences.Material And Method-This is a two years retrospective and one year prospective study of spinal injuries in children and adolescent age up to 18 years admitted in spinal injury unit of orthopaedics surgery King George ' s Medical University Lucknow to evaluate incidence, etiology and early outcome. Following variables were studied in these retrospective and prospective-(1) age and sex (2) injury mechanism (3) associated injuries (4) injury level (neurological and radiological) (5) management and early outcome (6) deformity evaluation Result-Total number of patients was 82 of which 68 were retrospective and 26 were prospective, incidence was 13.21/ year/1000, male female ratio 3.1:1, no infant, toddlers -6(7.31%) ,school going 17(21.73%) ,adolescent 59(71.95%). Most common mechanism of injury was fall from height followed by road traffic accident, most common neurological and radiological level C5-C7, conservative management done in 78 and operative in 4 patients of which 35 improve, 23 not improve, 16 drop out and 4 expired. In prospective study FIM score increase in all patient except one and Barthal index not improve in two patients. Deformity present in 21 prospective and 4 retrospective patients kyphotic deformity of >15 degree found in13 patients a mild progression of 4.23 degree was noted in follow up.Conclusions-In children and adolescent the incidence of spinal injury, mechanism of injury, neurological and vertebral level are different at different age groups and outcome is depends on extent of injury complete(A), incomplete(B,C,D) of ASIA impairment scale and motor and sensory score after spinal shock is over. The development of deformity is determined by age, extent of injury, vertebral level at the time of injury.Keywords--Demography, functional independence measure (FIM), Cobb's angle, and Barthal index.

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Section: Observations and Discussionsupporting

confidence: 83%

Section: Observations and Discussionmentioning

confidence: 99%

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A retrospective and prospective study of spinal injuries in children and adolescent- incidence etiology and early outcome

Krishna¹

2012

iosrphr

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“…The pediatric population, unlike adults, has increased ability to recover following neurologic injury. Wang et al[ 14] confirmed that 6 of 20 pediatric patients that presented with Frankel grade A injuries improved neurologically. Of note, five patients became ambulatory and no improvement was seen in the immediate postinjury period.…”

Section: Discussionmentioning

confidence: 54%

Thoracolumbar Fracture-Dislocation in Child Abuse: Case Report, Closed Reduction Technique and Review of the Literature

Sieradzki

Sarwark²

2008

Pediatr Neurosurg

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There have been very few reports in the literature of management of thoracolumbar fracture dislocations in very young children. The following is a presentation of one of these rare cases that was treated using a closed reduction method that has been little described in the medical literature. A 14-month-old child suffered a fracture dislocation at T₁₂–L₁ from nonaccidental trauma. The patient was neurologically intact upon admission. Treatment consisted of closed manual reduction and hyperextension casting under sedation. At 22-month follow-up, the patient displayed excellent clinical and radiographic results and remained neurologically intact. The operative technique is presented in detail and relevant literature reviewed. We propose that closed reduction and extension casting may be an acceptable treatment for infantile thoracolumbar fracture dislocations in neurologically intact patients.

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“…In the presence of dislocation, pediatric spinal instrumentation is the choice of treatment [13, 14]. Although spontaneous correction of the clinical deformity occurs in some pediatric cases which present with subluxation, complete dislocation cannot be managed conservatively [15]. …”

Section: Discussionmentioning

confidence: 99%

Complete L1-L2 Lateral Dislocation without Fracture and Neurologic Deficit in a Child

Güzel

Belen²,

Tatlı³

et al. 2006

Pediatr Neurosurg

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Spinal injuries in the infantile age group are relatively rare, mainly due to anatomical and biomechanical features of the pediatric spine. With its hypermobile character, pediatric spine can withstand trauma without fracture, and the elastic nature of the young spine allows easy slippage between segments, especially under the age of 8. Clinically, a few of the cases present with subluxation only, which seldom involve the lumbar level. We report an extremely rare case of traumatic complete upper lumbar lateral lystesis in a 3-year-old boy. The patient was treated conservatively and followed up for 2 years with some degree of correction.

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High Rates of Neurological Improvement Following Severe Traumatic Pediatric Spinal Cord Injury

Abstract: Recovery of neurologic function following severe traumatic spinal cord injury occurs with a significantly greater incidence in children than adults, and these improvements can occur over a prolonged postinjury period.

Cited by 87 publications

References 17 publications

A retrospective and prospective study of spinal injuries in children and adolescent- incidence etiology and early outcome

A retrospective and prospective study of spinal injuries in children and adolescent- incidence etiology and early outcome

Thoracolumbar Fracture-Dislocation in Child Abuse: Case Report, Closed Reduction Technique and Review of the Literature

Complete L1-L2 Lateral Dislocation without Fracture and Neurologic Deficit in a Child

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