As published in Developmental Medicine & Child Neurology
We wanted to determine the epidemiology and complications of spinal cord injuries (SCIs) in children injured at 5 years of age and younger who were seen between 1981 and 2008 at a children’s hospital in the USA.
Of particular concern are the complications of SCI (e.g. scoliosis, hip dysplasia, pressure sores, autonomic dysreflexia, and the need for intermittent catheterization and bowel management strategies), which have a tremendous impact on quality of life, as well as on financial resources. Demographic and injury‐related factors included age at injury, etiology, level of injury, American Spinal Injury Association Impairment Scale (AIS), and SCIs without radiological abnormalities (SCIWORA). We compiled the results of the 159 individuals seen (92 males, 67 females) median age at injury was 2 years (range 0y–5y 11mo). Forty‐nine percent were injured in vehicular accidents, 60% had complete injuries, 66% had paraplegia, and 72% had SCIWORA. Ninety‐six percent developed scoliosis, 57% had hip dysplasia, and 7% had latex allergy. Thirty‐four percent with injuries at or above T6 experienced autonomic dysreflexia, 41% developed pressure ulcers, and 61% experienced spasticity. Of those without bowel or bladder control, 82% were on intermittent catheterization and 69% were on a bowel program. Median age of initiating wheelchair use was 3 years 4 months (range 1y 2mo–12y 5mo). Twenty‐four were community ambulators, and they were more likely to have AIS D lesions (half the key muscle functions below the level of injury have a muscle grade 3 or greater) and less likely to have skeletal complications.
Our interpretation of the data was the epidemiology, complications, and manifestations of SCIs in children injured at a young age are unique and differ distinctively from adolescent and adult‐onset SCIs.
This article was authored by:
- Andrea L Behrman, PhD, PT, FAPTA
- Shelley A Trimble, PT
Read the Complete Published Article in Developmental Medicine & Child Neurology, a Wiley Publication.