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Epidemiology, Clinical Features and Consequences of Spinal Cord Injury in Children

Haider Darain¹, Aatik Arsh², Amir Zeb²

¹IPMR, Khyber Medical University, Peshawar.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|June 29, 2018

Insights

Pediatric Spinal Cord Injury (SCI) in Pakistan is primarily caused by firearm and bomb blast injuries, unlike in other countries. These children, similar to adults, are highly susceptible to developing pressure ulcers.

Area of Science:

Pediatric Traumatology
Neurology
Epidemiology

Background:

Spinal Cord Injury (SCI) in children presents unique epidemiological and clinical challenges.
Understanding the specific causes and consequences of pediatric SCI is crucial for targeted interventions.

Purpose of the Study:

To elucidate the epidemiology, clinical features, and outcomes of Spinal Cord Injury (SCI) in pediatric patients.
To identify the primary causes and common complications of SCI in children within the study region.

Main Methods:

A case series study was conducted at the Paraplegic Centre, Hayatabad, Peshawar, between July 2011 and March 2017.
Data from 102 pediatric SCI patients (age ≤ 15 years) were analyzed for demographics, injury characteristics, and complications, excluding foreign nationals and readmissions.

Main Results:

Firearm injuries (38.2%) and falls from height (22.5%) were the leading causes of SCI in children.
The majority of patients (80.4%) presented with complete SCI (ASIA A), with the thoracic region being the most common site of injury.
Pressure ulcers were a significant complication, affecting 49.0% of patients, with 30.0% experiencing Grade IV ulcers.

Conclusions:

Pediatric SCI causes in Pakistan, notably firearm and bomb blast injuries, differ from global trends.
Children with SCI, mirroring adult populations, face a high risk of developing pressure ulcers.
These findings highlight the need for region-specific prevention and management strategies for pediatric SCI.

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Abstract

Objective:

To describe epidemiology, clinical features and clinical consequences of Spinal Cord Injury (SCI) in children.

Study Design:

Case series.

Place And Duration Of Study:

Paraplegic Centre, Hayatabad, Peshawar, from July 2011 to March 2017.

Methodology:

SCI patients having age up to 15 years, admitted to Paraplegic Centre, were inducted in 2017. Exclusion criteria was foreign-national SCI patients, and/or SCI patients re-admitted to paraplegic centre. List of all SCI patients admitted to the centre was retrieved and 102 patients were identified. Data of these patients was evaluated for demographic information, physiological intactness (complete SCI/incomplete SCI), neurological level and complications.

Results:

A total of 102 patients (66 males and 36 females) with mean age 10.9 ±3.7 years were included in this study. Firearm injury was the most common cause (n=39, 38.2%) of SCI in these patients, followed by fall from height (n=23, 22.5%), road traffic accidents (n=14, 13.7%), and weight fallen over (n=14, 13.7%). Bomb blast injury (n=7, 6.9%), diving accident (n=3, 2.9%), and sports related injuries (n=2, 2.0%). Majority of the patients (n=82, 80.4%) had complete SCI (ASIA A); the commonest SCI level was thoracic region (n=59, 57.8%) and the least reported region was (n=14, 13.7%) cervical. Out of the total, 50 (49.0%) patients had pressure ulcer in which 15 (30.0%) patients were having grade IV pressure ulcer, 9 (18.0%), 15 (30.0%) and 11 (22.0%) patients were had grade I, grade II and grade III pressure ulcer, respectively.

Conclusion:

Majority of causes of SCI in children are similar to those reported in adult population. However, the commonest causes of SCI in children in Pakistan were firearm injury and bomb blast, which are rarely reported in other countries. Like adult population, these children with SCI are prone to developing pressure ulcer.

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