An Investigation into Different Types of Paediatric Spinal Cord Injury: Their Management and Prevention
Presented in National Medical Students Paediatric Conference (NMSPC) 2013, Brighton, UK
Rachael Grupping
St Bartholomew`s and The Royal London Medical School, UK
The level and types of paediatric spinal cord injury (SCI) vary over age groups and as the paediatric spine and surrounding musculature and ligaments develop to become more like the adult spine. Due to these differences SCI without radiographic abnormality (SCIWORA) is much more prevalent in the paediatric population. This literature review looked at the mechanisms of spinal injury in the paediatric population and the resulting types and level at which the SCI is sustained.

The management and the long-term complications commonly experienced after paediatric SCI depend on both the developmental age at which the injury is sustained as well as the complexity of the injury. Treatment cannot simply be translated from adult guidelines, as some types of injury are almost unique to paediatric spinal trauma. Each paediatric SCI is evaluated and managed on an individual basis and paediatric guidelines are used until the spine has developed an adult spinal profile. The decision to intervene surgically in paediatric SCI, especially upon the thoracic spine is complicated by the desire to prevent growth arrest, before the spine develops a more adult structure, approximately age 12, surgery is considered on a case-by-case basis.

There are recognised risk factors for SCI in children and recommendations and preventative measures outlined by both NICE (National Institute for Health and Care Excellence) and World Health Organization (WHO) as well as changes in legislation have lead to reductions in the incidence of paediatric SCI. However, more still needs to be done and there is still research needed to improve the outcome and long-term quality of life for those with paediatric SCI.
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