Spinal cord injuries in children in British Columbia

Abstract

Abstract. Fifteen children who sustained traumatic spinal cord injury in British Columbia over a 1 3 -year period have been reviewed. The aetiology, incidence of spinal fracture, length of hospitalisation and subsequent spinal surgery, and their self-care, transfer and ambulatory abilities, bowel and bladder management, schooling, employment and place of abode have been determined.

Pediatric Spinal Trauma: Vertebral Column and Spinal Cord Injuries in Children

“…The very young appear to tolerate SCI poorly. In contrast, adolescents (ages 9-16 years) appear to sustain injuries of an intermediate severity between that of young chil dren and adults [1,3,4,18,19,25,27,28,33,45,63,84,101,118]. The lack of data regarding the prognosis for recovery of neurological function after SCI is the most striking inadequacy of the pediatric SCI literature.…”

“…A large proportion of children die at the accident scene or shortly thereafter [3,8,12,63,119,120], Of the victims who sustain spinal injuries and survive the initial acci dent, another 20% die within 3 months [18,19,24,27,33,84], Life expectancy diminishes with increasingly se vere neurological injuries. Quadriplegics have shorter life expectancies than paraplegics, and patients with in complete neurological injuries have a longer life expec tancy than patients with complete injuries [2,8,11,12,[119][120][121][122]137], However, compared to other age-groups with SCI, children who survive the initial hospitaliza tion have a higher 5-year survival rate [3,8,12,18,27,33,63,84,119,120], Most reports regarding the initial neurological status after SCI suggest a higher percentage of complete SCI in children compared to adults (table 6) [1,3,4,18,19,25,27,28,33,45,63,…”

“…Children up to the age of 15 years sustain between 1 and 14% of all spinal injuries, a quarter of the rate of SCI in the peak age-group (ages [16][17][18][19][20][21][22][23][24] [1,2,4,6,9,13,19,24,25,27,29,33,46,78,[83][84][85]97]. This incidence is the lowest rate of SCI associated with any age-group.…”

“…Thirty percent to 90% of children with SCI will develop a spinal deformity [4,46,65,70,85,[128][129][130][131]. In decreasing order of frequency, these defor mities include scoliosis or lateral curvature, progressive kyphotic deformities, or progressive lordosis.…”

“…The reported incidence of SCI WORA ranges from 5 to 70% of all pediatric SCIs [1,4,6,18,25,27,28,36,38,58,63,72,83,84], If referral biases and the introduction of CT studies are included, the incidence of SCI WORA appears to approximate 15-25% of all pediatric SCIs [3,18,28,63,83]. SCIWORA occurs almost exclusively among pediatric age-groups [19,24,25,28,[36][37][38], Twothirds of the cases of SCIWORA occur in patients 8 years or younger.…”